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

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• 作者：Fanfan Hou (1) (2)
  Jianping Jiang (1) (2)
  Jianghua Chen (3)
  Xueqing Yu (4)
  Qiugen Zhou (1) (2)
  Pingyan Chen (5)
  Changlin Mei (6)
  Fei Xiong (7)
  Wei Shi (8)
  Wei Zhou (9)
  Xusheng Liu (10)
  Shiren Sun (11)
  Di Xie (1) (2)
  Jun Liu (1) (2)
  Ping Zhang (3)
  Xiao Yang (4)
  Yixiang Zhang (6)
  Yanmin Zhang (7)
  Xinling Liang (8)
  Zhimin Zhang (9)
  Qizhan Lin (10)
  Yan Yu (11)
  Shengjie Wu (1) (2)
  Xin Xu (1) (2)
  
• 关键词：Cardiovascular morbidity ; Dialysis modality ; Risk factor
• 刊名：BMC Nephrology
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：13
• 期：1
• 全文大小：182KB
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  4. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, / et al.: Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. / Circulation 2003,108(17):2154-169. CrossRef
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  7. Hou FF, Ma ZG, Mei CL, Rong S, Huang SM, Liu XR, / et al.: Epidemiology of cardiovascular risk in Chinese chronic kidney disease patients. / Zhonghua Yi Xue Za Zhi 2005,85(11):753-59.
  8. Yoshino M, Kuhlmann MK, Kotanko P, Greenwood RN, Pisoni RL, Port FK, / et al.: International differences in dialysis mortality reflect background general population atherosclerotic cardiovascular mortality. / J Am Soc Nephrol 2006,17(12):3510-519. CrossRef
  9. Zuo L, Wang M: Current burden and probable increasing incidence of ESRD in China. / Clin Nephrol 2010,74(Suppl 1):S20-S22.
  10. Cheung AK, Sarnak MJ, Yan G, Dwyer JT, Heyka RJ, Rocco MV, / et al.: Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients. / Kidney Int 2000,58(1):353-62. CrossRef
  11. Longenecker JC, Coresh J, Powe NR, Levey AS, Fink NE, Martin A, / et al.: Traditional cardiovascular disease risk factors in dialysis patients compared with the general population: the CHOICE Study. / J Am Soc Nephrol 2002,13(7):1918-927. CrossRef
  12. Baber U, de Lemos JA, Khera A, McGuire DK, Omland T, Toto RD, / et al.: Non-traditional risk factors predict coronary calcification in chronic kidney disease in a population-based cohort. / Kidney Int 2008,73(5):615-21. CrossRef
  13. Quinn RR, Hux JE, Oliver MJ, Austin PC, Tonelli M, Laupacis A: Selection Bias Explains Apparent Differential Mortality between Dialysis Modalities. / J Am Soc Nephrol 2011,22(8):1534-542. CrossRef
  14. Mehrotra R, Chiu YW, Kalantar-Zadeh K, Bargman J, Vonesh E: Similar outcomes with hemodialysis and peritoneal dialysis in patients with end-stage renal disease. / Arch Intern Med 2011,171(2):110-18. CrossRef
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  16. Vonesh EF, Snyder JJ, Foley RN, Collins AJ: The differential impact of risk factors on mortality in hemodialysis and peritoneal dialysis. / Kidney Int 2004,66(6):2389-401. CrossRef
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  23. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2369/13/94/prepub
  
• 作者单位：Fanfan Hou (1) (2)
  Jianping Jiang (1) (2)
  Jianghua Chen (3)
  Xueqing Yu (4)
  Qiugen Zhou (1) (2)
  Pingyan Chen (5)
  Changlin Mei (6)
  Fei Xiong (7)
  Wei Shi (8)
  Wei Zhou (9)
  Xusheng Liu (10)
  Shiren Sun (11)
  Di Xie (1) (2)
  Jun Liu (1) (2)
  Ping Zhang (3)
  Xiao Yang (4)
  Yixiang Zhang (6)
  Yanmin Zhang (7)
  Xinling Liang (8)
  Zhimin Zhang (9)
  Qizhan Lin (10)
  Yan Yu (11)
  Shengjie Wu (1) (2)
  Xin Xu (1) (2)
  
  1. Division of Nephrology, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou, 510515, China
  2. Key Lab for Organ Failure Research, Ministry of Education, Guangzhou, China
  3. Division of Nephrology, The First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
  4. Division of Nephrology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
  5. Department of Biostatistics, Southern Medical University, Guangzhou, China
  6. Division of Nephrology, Changzheng Hospital, Secondary Military Medical University, Shanghai, China
  7. Division of Nephrology, The First People’s Hospital, Wuhan, China
  8. Division of Nephrology, Guangdong General Hospital, Guangzhou, China
  9. Division of Nephrology, The 309th Hospital of People’s Liberation Army, Beijing, China
  10. Division of Nephrology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
  11. Division of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
  

文摘

Background Cardiovascular disease (CVD) is the main cause of death in patients on chronic dialysis. The question whether dialysis modality impacts cardiovascular risk remains to be addressed. China Collaborative Study on Dialysis, a multi-centers cohort study, was performed to evaluate cardiovascular morbidity during maintenance hemodialysis (HD) and peritoneal dialysis (PD). Method The cohort consisted of chronic dialysis patients from the database of 9 of the largest dialysis facilities around China. The inclusion period was between January 1, 2005, and December 1, 2010. Cardiovascular morbidity was defined as the presence of clinically diagnosed ischemic heart disease, heart failure, peripheral vascular disease, and/or stroke. The patients who had cardiovascular morbidity before initiation of dialysis were excluded. Data collection was based on review of medical record. Result A total of 2,388 adult patients (1,775 on HD and 613 on PD) were enrolled. Cardiovascular morbidity affected 57% patients and was comparable between HD and PD patients. However, clinically diagnosed ischemic heart disease and stroke was more prevalent in PD than HD patients. When the patients were stratified by age or dialysis vintage, the cardiovascular morbidity was significantly higher in PD than HD among those aged 50?years or older, or those receiving dialysis over 36?months. Multivariate analysis revealed that the risk factors for cardiovascular morbidity had different pattern in PD and HD patients. Hyperglycemia was the strongest risk factor for cardiovascular morbidity in PD, but not in HD patients. Hypertriglyceridemia and hypoalbuminemia were independently associated with CVD only in PD patients. Conclusions Cardiovascular morbidity during chronic dialysis was more prevalent in PD than HD patients among those with old age and long-term dialysis. Metabolic disturbance-related risk factors were independently associated with CVD only in PD patients. Better understanding the impact of dialysis modality on CVD would be an important step for prevention and treatment.