Sudden Death in End Stage Renal Disease: Comparing Hemodialysis versus Peritoneal Dialysis

Abstract

Background/Aims: This study aimed to evaluate total and sudden death (SD) in a cohort of dialysis patients, comparing hemodialysis (HD) vs. peritoneal dialysis (PD). Methods: This is a multicenter retrospective cohort study. Results: Deaths were 626 out of 1,823 in HD and 62 of 249 in PD patients. HD patients had a greater number of comorbidities (p < 0.05). PD patients had a lower risk of death than HD patients (p < 0.001); however, the advantage decreased with time (p < 0.001). Mortality predictors were left ventricular ejection fraction (LVEF) ≤35%, older age, ischemic heart disease, diabetes mellitus, previous stroke, and atrial fibrillation (p < 0.03). SDs were 84:71 in HD and 13 in PD population (12.1 and 22.8% of all causes of death, respectively). A non-significant risk of SD among PD compared to HD patients was detected. SD predictors were older age, ischemic heart disease, and LVEF ≤35% (p < 0.05). Conclusions: HD patients showed a greater presence of comorbidities and reduced survival compared to PD patients; however, the incidence of SD does not differ in the 2 populations. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=464347.

Increased Frequency of In-Center Hemodialysis as Rescue Therapy: Impact on Hospitalization for Acute Cardiovascular Events

“…According to another previous study, increased LVEDD was an independent predictor of all-cause mortality [27]. In addition, Genovesi et al [28] reported that LVEF ≤35% in dialysis patients was a predictor for allcause and sudden death mortality. Meanwhile, compared with conventional HD, frequent nocturnal HD improved LV mass [8,29] and LVEF [12], and reduced blood pressure [11].…”

The comparison of risk of stroke in patients with peritoneal dialysis and hemodialysis: A systematic review and meta‐analysis

“…A total of 33 studies underwent a full‐length article review, and 18 of them were excluded as they did not include controls or did not report the outcome of interest. Therefore, a total of 15 studies met our inclusion criteria and were included in the meta‐analysis. Figure outlines our search methodology and selection process.…”

“…It is unclear whether the choice of dialysis modality affects the risk of stroke . Each renal replacement modality causes physiological changes that may affect the risk of stroke in a different way .…”

“…Although the choice of renal replacement therapy usually depends on many factors, it is still important to assess whether the choice of dialysis modality differs with regard to stroke risk. Available data comparing stroke risk in patients on chronic peritoneal dialysis (PD) compared to those on hemodialysis (HD) are inconsistent …”

Impact of Hybrid Therapy Comprising Peritoneal Dialysis and Hemodialysis on Acute Cardiovascular Events

“…Another study reported that LV masses were associated with all-cause mortality and cardiovascular mortality for ESKD patients [26]. In addition, Genovesi et al [27] reported that one predictor of all-cause mortality and sudden death mortality was LVEF ≤35% for dialysis patients. However, in a multicenter, randomized, controlled trial, treatment of patients with hypertension for 18 months promoted favorable effects for LV remodeling.…”