Influence of Different Types of β-Blockers on Mortality in Patients on Hemodialysis

Abstract

Previous results regarding the association between types of β-blockers and outcomes in patients on hemodialysis (HD) were inconsistent. Our study aimed to evaluate patient survival according to the type of β-blockers administered using a large sample of patients with maintenance HD. Our study included patients on maintenance HD patients from a national HD quality assessment program (n = 54,132). We divided included patients into four groups based on their use and type; Group 1 included patients without a prescription of β-blockers, Group 2 included patients with a prescription of dialyzable and cardioselective β-blockers, Group 3 included patients with a prescription of non-dialyzable and non-cardioselective β-blockers, and Group 4 included patients with prescription of non-dialyzable and cardioselective β-blockers. The number of patients in Groups 1, 2, 3, and 4 were 34,514, 2789, 15,808, and 1021, respectively. The 5-year survival rates in Groups 1, 2, 3, and 4 were 69.3%, 66.0%, 68.8%, and 69.2%, respectively. Univariate Cox regression analyses showed the hazard ratios to be 1.10 (95% CI, 1.04–1.17) in Group 2 and 1.05 (95% CI, 1.02–1.09) in Group 3 compared to Group 1. However, multivariate Cox regression analyses did not show statistical significance among the four groups. Our study showed that there was no significant difference in patient survival based on the use or types of β-blockers.

Clinical Impact of the Use of Warfarin in Patients with Atrial Fibrillation Undergoing Maintenance Hemodialysis

“…We evaluated all-cause mortality as the primary outcome, and hemorrhagic stroke, ischemic stroke, and cardiovascular events (CVE) as secondary outcomes. We evaluated the incidence of hemorrhagic stroke (I60, I61, I62) or ischemic stroke (I63) using the relevant ICD-10 codes after the end of the HD quality assessment program, and that of CVE, including myocardial infarction, stroke, and revascularization, regardless of survival or death, as shown in Table S2 [14]. To assess each secondary outcome, we analyzed patients without prior diagnosis of each condition in the year preceding the HD quality assessment period.…”

“…A retrospective analysis was conducted utilizing data from adult patients (age ≥ 18 years) undergoing maintenance HD (≥3 months and ≥2 times per week) who participated in the fourth (July and December 2013), fifth (July and December 2015), and sixth (March and August 2018) HD quality assessment programs performed by the Health Insurance Review and Assessment (HIRA) of the Republic of Korea [14]. In total, 21,846, 35,538, and 31,294 patients were included in the fourth, fifth, and sixth HD quality assessment programs, respectively.…”

Changes in pre‐haemodialysis serum creatinine levels over 2 years and long‐term survival in maintenance haemodialysis

“…We conducted a retrospective study of patients enrolled in a periodic HD quality assessment program and examined both program‐related and claims data. 8 , 9 South Korea operates under a mandatory single‐payer national healthcare insurance system, covering ~98% of its population. Under this system, patients may be required to pay a portion of the medical expenses for treatments covered by insurance, with the remainder billed by hospitals through the mandatory submission of itemized claims (including fees for procedures, surgeries and prescribed medications) and treatment outcomes (such as continued treatment, transfer, discharge, death or termination of care) to the Health Insurance Review and Assessment Service (HIRA).…”

“…Therefore, we defined CVE as MI, stroke and revascularization regardless of survival or death, as shown in Table S2 . 9 , 14 , 15 In cases where a patient was transferred to peritoneal dialysis or underwent kidney transplantation without experiencing an event, the time of transfer was considered the censoring point.…”