ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO829

Syncope and Collapse Is Associated with an Increased Risk of Cardiovascular Disease and Mortality in Patients Undergoing Dialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Author

  • Yu, Tung-Min, Taichung Veterans General Hospital, Taichung ---, Taiwan
Background

Patients undergoing dialysis have a higher risk of cardiovascular disease and mortality than the general population. Syncope and collapse (SC) is often observed in patients before and after dialysis sessions. However, the epidemiology of SC is undetermined and the association between SC and cardiovascular outcomes in a dialysis population has not been discussed. This study explored the impact of SC on cardiovascular events and mortality.

Methods

This study retrospectively examined data of patients undergoing dialysis from population-based medical registries between 1998 and 2011. Patients undergoing dialysis who have SC (N = 3876) were selected as the study cohort and those without SC who were propensity score-matched at a 1:1 ratio were included as controls. Major adverse cardiovascular events (MACEs), included acute coronary syndrome (ACS), arrhythmia or cardiac arrest, stroke, and overall mortality, were evaluated and compared in both cohorts.

Results

In 2011, the incidence and prevalence rates of SC were 7.05% and 10.8%, respectively, in the dialysis population. The mean follow-up periods until the occurrence of ACS, arrhythmia or cardiac arrest, stroke, and overall mortality in the SC cohort were 3.51 ± 2.90, 3.43 ± 2.93, 3.74 ± 2.97, and 3.76 ± 2.98 years, respectively. Compared with the patients without SC, those with SC had higher incidence rates of ACS (30.1 vs. 24.7 events/1000 people/year), arrhythmia or cardiac arrest (6.75 vs. 3.51 events/1000 people/year), stroke (51.6 vs. 35.7 events/1000 people/year), and overall mortality (127.7 vs. 77.9 deaths/1000 people/year). The SC cohort also had higher risks of ACS, arrhythmia or cardiac arrest, stroke, and overall mortality (adjusted hazard ratios: 1.28 [95% confidence interval (CI) = 1.11–1.46], 2.05 [95% CI = 1.50–2.82], 1.48 [95% CI = 1.33–1.66], and 1.79 [95% CI = 1.67–1.92], respectively) than did the non-SC cohort.

Conclusion

SC was significantly associated with cardiovascular events and overall mortality in the patients on dialysis. SC may serve as a prodrome for cardiovascular comorbidities, thereby assisting clinicians in identifying high-risk patients.