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Surgical Techniques for Catheter Placement and 5/6 Nephrectomy in Murine Models of Peritoneal Dialysis
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Preexisting Cardiovascular Disease, Hypertension, and Mortality in Peritoneal Dialysis

Juan Wu1, Xiaojiang Zhan2, Yueqiang Wen3

  • 1Urology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), 310014 Hangzhou, Zhejiang, China.

Reviews in Cardiovascular Medicine
|July 30, 2024
PubMed

Insights

Preexisting cardiovascular disease (CVD) and hypertension significantly increase mortality risk in peritoneal dialysis (PD) patients. The combination of both conditions poses the highest mortality risk, highlighting their additive prognostic impact.

Area of Science:

  • Nephrology and Cardiovascular Medicine
  • Epidemiology and Public Health

Background:

  • Cardiovascular disease (CVD) and hypertension are known risk factors for poor outcomes in peritoneal dialysis (PD) patients.
  • The combined prognostic impact of preexisting CVD and hypertension in PD patients requires further comprehensive evaluation.

Purpose of the Study:

  • To investigate the joint associations between preexisting cardiovascular disease (CVD), hypertension, and mortality in incident peritoneal dialysis (PD) patients.
  • To determine the independent and combined prognostic significance of CVD and hypertension on all-cause and CVD-specific mortality in PD.

Main Methods:

  • Retrospective cohort study involving 3073 incident PD patients from five Chinese dialysis centers (2005-2018).
  • Cox regression models and Fine-Gray competing risk models were used to analyze the associations between preexisting CVD, hypertension, and mortality outcomes.
  • Adjustments were made for relevant confounding factors to isolate the impact of CVD and hypertension.

Main Results:

  • Over a median follow-up of 33.7 months, 18.6% of patients died, with 9.3% due to CVD.
  • Patients with both preexisting CVD and hypertension had the highest risk of all-cause mortality (HR: 3.97) and CVD mortality (HR: 4.68) compared to controls.
  • Individually, preexisting CVD (HR: 2.21 for all-cause mortality) and hypertension (HR: 1.83 for all-cause mortality) also significantly increased mortality risk.

Conclusions:

  • Preexisting cardiovascular disease and hypertension have additive prognostic value for mortality in PD patients.
  • Preexisting CVD demonstrates a stronger association with mortality risk than hypertension in this PD population.
  • These findings underscore the importance of managing cardiovascular risk factors in PD patients to improve survival outcomes.
Abstract

Keywords:
cardiovascular diseasehypertensionmortalityperitoneal dialysisprognosis

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