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China collaborative study on dialysis: a multi-centers cohort study on cardiovascular diseases in patients on

Fanfan Hou1, Jianping Jiang, Jianghua Chen

  • 1Division of Nephrology, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, China. ffhouguangzhou@163.com

BMC Nephrology
|September 1, 2012
PubMed

Insights

Cardiovascular disease risk is higher in older, long-term dialysis patients on peritoneal dialysis (PD) compared to hemodialysis (HD). Metabolic factors like hyperglycemia impact PD patients more significantly.

Area of Science:

  • Nephrology
  • Cardiology
  • Epidemiology

Background:

  • Cardiovascular disease (CVD) is a leading cause of mortality in patients undergoing chronic dialysis.
  • The influence of dialysis modality on cardiovascular risk requires further investigation.
  • The China Collaborative Study on Dialysis evaluated cardiovascular morbidity in hemodialysis (HD) and peritoneal dialysis (PD) patients.

Purpose of the Study:

  • To compare cardiovascular morbidity between patients on maintenance hemodialysis (HD) and peritoneal dialysis (PD).
  • To identify risk factors associated with cardiovascular morbidity in different dialysis modalities.

Main Methods:

  • A multi-center cohort study included 2,388 adult chronic dialysis patients in China (2005-2010).
  • Cardiovascular morbidity was defined as diagnosed ischemic heart disease, heart failure, peripheral vascular disease, and/or stroke.
  • Patients with pre-existing cardiovascular morbidity were excluded; data were collected via medical record review.

Main Results:

  • Cardiovascular morbidity affected 57% of patients, with comparable rates between HD and PD overall.
  • Ischemic heart disease and stroke were more prevalent in PD patients.
  • Higher cardiovascular morbidity in PD versus HD was observed in patients aged ≥50 years or on dialysis >36 months. Hyperglycemia, hypertriglyceridemia, and hypoalbuminemia were significant risk factors in PD patients.

Conclusions:

  • Cardiovascular morbidity is more prevalent in older, long-term PD patients compared to HD patients.
  • Metabolic disturbances are independently associated with CVD specifically in PD patients.
  • Understanding dialysis modality's impact on CVD is crucial for prevention and treatment strategies.
Abstract

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