Abstract: FR-PO833

Trends in Emergency Hospitalization for Cardiovascular and Infectious Diseases between Hemodialysis and Peritoneal Dialysis over 20 Years

Session Information

Category: Dialysis

  • 606 Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular

Authors

  • Banshodani, Masataka, Tsuchiya General Hospital, Hiroshima, Japan
  • Kawanishi, Hideki, Tsuchiya General Hospital, Hiroshima, Japan
  • Moriishi, Misaki, Tsuchiya General Hospital, Hiroshima, Japan
  • Shintaku, Sadanori, Tsuchiya General Hospital, Hiroshima, Japan
  • Tsuchiya, Shinichiro, Tsuchiya General Hospital, Hiroshima, Japan
Background

In hemodialysis (HD), volume and electrolyte status drastically change, whereas peritoneal dialysis (PD) is a continuous dialysis and thus maintain a stable volume and electrolyte status. However, no studies have evaluated trends of hospitalization for cardiovascular diseases (CVDs) and infectious diseases (IDs) according to dialysis modality over time.

Methods

This is a retrospective observational cohort study that evaluated 13,078 hospitalizations (1,955 HD and 497 PD patients with end-stage renal disease) to clarify associations between dialysis modality and emergency hospitalization for CVDs (HD, 1,704; PD, 261 times) and IDs (excluding PD-related infections; HD, 970; PD, 132 times) at a single institution over 20 years (1995–2014).

Results

The CVD hospitalization rate (per 100 person-years) in PD remained at the same level over 20 years (1995–1999, 2000–2004, 2005–2009, 2010–2014; 9.7, 6.5, 10.5, and 7.2, respectively), while in HD, the rate decreased (15.4, 8.3, 5.7, and 6.3; every P < 0.001, v.s. 1995–1999). The ID hospitalization rate in PD decreased in the last 5 years (5.0, 5.0, 5.4, and 2.5, respectively; P = 0.001, 2005–2009 v.s. 2010–2014). In HD, the rate increased (5.9, 3.9, 3.8, and 5.4; P < 0.001, 2005–2009 v.s. 2010–2014). In the logistic regression analyses, the odds of dialysis vintage (odds ratio [OR], 3.58; confidence interval [CI], 2.25–5.77; P < 0.001) and HD (OR, 2.04; CI, 1.57–2.68, P < 0.001) were significantly higher for CVD hospitalization in the first 10 years, but the significances disappeared in the last 10 years. Although no significance was found in first 10 years, the odds of male sex (OR, 1.27; CI, 1.08–1.51, P = 0.004) and HD (OR, 1.52; CI, 1.19–1.96, P < 0.001) were significantly higher for ID hospitalization in the last 10 years.

Conclusion

The risk of CVD hospitalization was significantly higher in HD than in PD in the first 10 years, but the risk disappeared in the last 10 years. However, the increased risk of ID hospitalization in HD should be solved. Further multicenter studies are needed to compare hospitalization rates among dialysis modalities.