The incidence and associated factors of sudden death in patients on hemodialysis: 10-year outcome of the Q-cohort study

Hiroto Hiyamuta, Shigeru Tanaka, Masatomo Taniguchi, Masanori Tokumoto, Kiichiro Fujisaki, Toshiaki Nakano, Kazuhiko Tsuruya, Takanari Kitazono

研究成果: Contribution to journalArticle査読

7 被引用数 (Scopus)

抄録

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.

本文言語英語
ページ(範囲)306-318
ページ数13
ジャーナルJournal of atherosclerosis and thrombosis
27
4
DOI
出版ステータス出版済み - 2020

All Science Journal Classification (ASJC) codes

  • 内科学
  • 循環器および心血管医学
  • 生化学、医学

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