TY - JOUR
T1 - The incidence and associated factors of sudden death in patients on hemodialysis
T2 - 10-year outcome of the Q-cohort study
AU - Hiyamuta, Hiroto
AU - Tanaka, Shigeru
AU - Taniguchi, Masatomo
AU - Tokumoto, Masanori
AU - Fujisaki, Kiichiro
AU - Nakano, Toshiaki
AU - Tsuruya, Kazuhiko
AU - Kitazono, Takanari
N1 - Funding Information:
This study was supported by the Kidney Foundation (H19 JKFB 07-13, H20 JKFB 08-8, H23 JKFB 11-11) and the Japan Dialysis Outcome Research Foundation (H19-076-02, H20-003). The funders of this study had no role in study design, collection, analysis, interpretation of data, writing the report, and the decision to submit the report for publication.
Publisher Copyright:
© 2020 Japan Atherosclerosis Society.
PY - 2020
Y1 - 2020
N2 - Aim: The incidence of sudden death and its risk factors in patients on hemodialysis remain unclear. This study aimed to clarify the incidence of sudden death and its risk factors in Japanese patients on hemodialysis. Methods: A total of 3505 patients on hemodialysis aged ≥ 18 years were followed for 10 years. Multivariate-adjusted hazard ratio (HR) with 95% confidence interval (95% CI) of each risk factor of sudden death were cal-culated using a Cox proportional hazards model. Results: During the 10-year follow-up, 1735 patients died, including 227 (13%) sudden deaths. The incidence rate of sudden death was 9.13 per 1000 person-years. In multivariable-adjusted Cox analysis, male sex (HR 1.67; 95% CI 1.20–2.33), age (HR 1.44; 95% CI 1.26–1.65 per 10-year higher), the presence of diabetes (HR 2.45; 95% CI 1.82–3.29), history of cardiovascular disease (HR 1.85; 95% CI 1.38–2.46), cardiothoracic ratio (HR 1.21; 95% CI 1.07–1.39 per 5% higher), serum C-reactive protein (HR 1.11; 95% CI 1.03–1.20 per 1-mg/dL higher), and serum phosphate (HR 1.15; 95% CI 1.03–1.30 per 1-mg/dL higher) were independent predictors of sudden death. A subgroup analysis stratified by sex or age showed that lower serum corrected calcium levels, not using vitamin D receptor activators in women, and a shorter dialysis session length in men or older people (≥ 65 years) increased the risk for sudden death. Conclusions: This study clarified the incidence of sudden death and its specific predictors in Japanese patients on hemodialysis.
AB - Aim: The incidence of sudden death and its risk factors in patients on hemodialysis remain unclear. This study aimed to clarify the incidence of sudden death and its risk factors in Japanese patients on hemodialysis. Methods: A total of 3505 patients on hemodialysis aged ≥ 18 years were followed for 10 years. Multivariate-adjusted hazard ratio (HR) with 95% confidence interval (95% CI) of each risk factor of sudden death were cal-culated using a Cox proportional hazards model. Results: During the 10-year follow-up, 1735 patients died, including 227 (13%) sudden deaths. The incidence rate of sudden death was 9.13 per 1000 person-years. In multivariable-adjusted Cox analysis, male sex (HR 1.67; 95% CI 1.20–2.33), age (HR 1.44; 95% CI 1.26–1.65 per 10-year higher), the presence of diabetes (HR 2.45; 95% CI 1.82–3.29), history of cardiovascular disease (HR 1.85; 95% CI 1.38–2.46), cardiothoracic ratio (HR 1.21; 95% CI 1.07–1.39 per 5% higher), serum C-reactive protein (HR 1.11; 95% CI 1.03–1.20 per 1-mg/dL higher), and serum phosphate (HR 1.15; 95% CI 1.03–1.30 per 1-mg/dL higher) were independent predictors of sudden death. A subgroup analysis stratified by sex or age showed that lower serum corrected calcium levels, not using vitamin D receptor activators in women, and a shorter dialysis session length in men or older people (≥ 65 years) increased the risk for sudden death. Conclusions: This study clarified the incidence of sudden death and its specific predictors in Japanese patients on hemodialysis.
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U2 - 10.5551/jat.49833
DO - 10.5551/jat.49833
M3 - Article
C2 - 31434843
AN - SCOPUS:85082979105
SN - 1340-3478
VL - 27
SP - 306
EP - 318
JO - Journal of Atherosclerosis and Thrombosis
JF - Journal of Atherosclerosis and Thrombosis
IS - 4
ER -
