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Abstract: PO1307

Combination of Hypertension and Preexisting Cardiovascular Disease and Mortality in Patients on Continuous Ambulatory Peritoneal Dialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Wu, Xianfeng, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, Shanghai, China
  • Wang, Niansong, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, Shanghai, China
  • Wu, Junnan, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China, Shanghai, China
Background

Little is known about whether combination of hypertension and pre-existing cardiovascular disease (CVD) is more strongly associated with outcomes compared with either comorbidity alone in patients on continuous ambulatory peritoneal dialysis (CAPD).

Methods

We conducted a retrospective study of 3073 incident Chinese patients on CAPD from five dialysis centers between January 1, 2005 and December 31, 2018 in a real-world setting. All patients were divided four groups: group 1 (patients without either hypertension or pre-existing CVD); group 2 (patients with only hypertension); group 3 (patients with only pre-existing CVD); group 4 (patients with both hypertension and pre-existing CVD). The association between interesting comorbidities and mortality was analyzed using Cox regression models.

Results

Over a median of 33.7 months of follow-up, 581 (18.6%) patients died, with 286 (9.3%) CVD mortality. The incidence of all-cause mortality was 32.2, 56.1, 74.4, and 131.0/1000 patient-years, and the incidence of CVD mortality was 15.0, 28.2, 34.7, and 69.6/1000 patient-years in group 1, 2, 3, and 4, respectively. Cumulative survival and CVD mortality-free survival were lowest in those with both hypertension and pre-existing CVD (Figure 1). After adjusting for the demographic characteristics and laboratory parameters, group 4, 3, and 2 had 3.07 (95% CI 2.23 to 4.22), 2.05 (95% CI 1.11 to 3.80), and 1.38 (95% CI 1.08 to 1.77) of hazard ratios for all-cause mortality, and 3.20 (95% CI 2.04 to 5.03), 2.09 (95% CI 0.85 to 5.15), and 1.56 (95% CI 1.09 to 2.23) of hazard ratios for CVD mortality, respectively, compared to the group 1.

Conclusion

Combination of hypertension and pre-existing CVD was more strongly associated with mortality compared to either comorbidity alone in CAPD patients.