标题:
The Trend of Hospitalizations for Acute-Cardiovascular and Infectious Diseases in Peritoneal Dialysis Compared to Hemodialysis over 20 Years
讲者:
Masataka Banshodani
单位:
Tsuchiya General Hospital
播放:
1397
论文摘要:
Introduction In hemodialysis (HD) patients, volume and electrolyte status drastically change, while peritoneal dialysis (PD) patients continuously dialyze and maintain a stable volume and electrolyte status. However, no reports have evaluated how the dialysis modality affects hospitalization for acute diseases on a long-term basis.
Methods We analyzed 11,111 hospitalizations of 1,955 HD patients and 1,969 hospitalizations of 497 PD patients to clarify the association between the dialysis modality and the hospitalizations for acute diseases, including acute-cardiovascular diseases (CVDs) (HD, 1,705; PD, 261 times) and infectious diseases (excluding PD-related infections) (HD, 984; PD, 132 times), at single institution every 5 years from 1995 to 2014.
Results In HD patients, the rate of acute CVD contributing to overall hospitalizations have been decreasing every 5 years: 1st-5th yr, 33%; 2nd-5th yr, 19% (P<0.001); 3rd-5th yr, 13% (P<0.001); 4th-5th yr, 9.5% (P<0.001) (P for vs. 1st-5th yr). In PD patients, although the rate of acute CVD contributing to overall hospitalizations in 1st-5th yr (20%) (P=0.02) was higher than that in 2nd-5th yr (12%), the rate has remained at the same level in recent years: 3rd-5th yr, 13% (P=0.70); 4th-5th yr, 12% (P=0.93) (P for vs. 2nd-5th yr). The rates of acute infectious disease contributing to overall hospitalizations have been decreasing in both HD [(1st-5th yr, 13%; 2nd-5th yr, 8.8% (P<0.001); 3rd-5th yr, 8.5% (P<0.001); 4th-5th yr, 7.9% (P<0.001) (P for vs. 1st-5th yr)] and PD [(1st-5th yr, 10%; 2nd-5th yr, 9.4% (P=0.7); 3rd-5th yr, 6.6% (P=0.07); 4th-5th yr, 4.2% (P=0.002) (P for vs. 1st-5th yr)] patients.
Conclusions The hospitalization rate for acute CVDs decreased over time in HD group, while this tendency was not observed in PD group. This findings may suggest the limitations of PD therapy for the control of CVD. Further multicenter studies comparing hospitalization rates among dialysis modalities are needed.