Skip to main content
main-content

01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Nephrology 1/2017

Dementia is a risk factor for major adverse cardiac and cerebrovascular events in elderly Korean patients initiating hemodialysis: a Korean national population-based study

Zeitschrift:
BMC Nephrology > Ausgabe 1/2017
Autoren:
Sung Min Jung, Clara Tammy Kim, Ea Wha Kang, Kyoung Hoon Kim, Shina Lee, Hyung Jung Oh, Seung-Jung Kim, Duk-Hee Kang, Kyu Bok Choi, Dong-Ryeol Ryu, Hyunwook Kim
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12882-017-0547-0) contains supplementary material, which is available to authorized users.

Abstract

Background

Dementia is common in end-stage renal disease (ESRD) patients on hemodialysis (HD) and is associated with worse outcomes. This study aimed to investigate the risk of major adverse cardiac and cerebrovascular event (MACCE) in elderly patients with dementia initiating HD.

Methods

Using the database from the Health Insurance Review & Assessment Service, we analyzed 10,171 patients aged 65 years or older who had initiated dialysis from 2005 to 2008. MACCE was defined as a composite outcome of all-cause mortality, nonfatal acute myocardial infarction, target vessel revascularization, and nonfatal ischemic and hemorrhagic stroke. The Kaplan-Meier method and Cox proportional hazards model were used, and further comparisons using propensity-score matching at 1:2 ratio were also performed.

Results

A total of 303 elderly patients (3.0%) had dementia at initiating HD. During follow-up, dementia was a significant predictor of MACCE after adjustment for confounding variables. In addition, further analyzed in the propensity-score matched groups, dementia was an independent predictor of both nonfatal ischemic stroke and all-cause mortality.

Conclusions

Dementia is an independent risk factor for mortality and ischemic stroke in elderly ESRD patients initiating HD. Patients with dementia who start dialysis should be closely monitored to reduce the risk of mortality and ischemic stroke.
Zusatzmaterial
Additional file 1: Table S1. Results of the Cox proportional hazards analysis for MACCE in all patients (N = 10,171). Table S2. Results of the Cox proportional hazards analysis for MACCE in propensity score-matched patients (N = 756). Abbreviations: MACCE, major adverse cardiac and cerebrovascular event. (DOCX 23 kb)
12882_2017_547_MOESM1_ESM.docx
Additional file 2: Figure S1. Kaplan Kaplan–Meier event-free survival curves and comparisons between patients with and without dementia by log-rank test in propensity score-matched patients (N = 756). (A) The incidence of MACCE was significantly higher in patients with dementia than those without dementia (P = 0.0304). (B) Patients without dementia showed better survival rate compared to patients with dementia (P = 0.0348). (C-E) There were no significant differences in event-free survival rates of nonfatal acute myocardial infarction, target vessel revascularization, and nonfatal hemorrhagic stroke (P = 0.31, P = 0.133, and P = 0.402, respectively). (F) However, the incidence of nonfatal ischemic stroke was significantly higher in patients with dementia than those without dementia (P = 0.0492). Abbreviations: MACCE, major adverse cardiac and cerebrovascular event. (TIF 476 kb)
12882_2017_547_MOESM2_ESM.tif
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2017

BMC Nephrology 1/2017 Zur Ausgabe

Neu im Fachgebiet Innere Medizin

Meistgelesene Bücher aus der Inneren Medizin

2017 | Buch

Rheumatologie aus der Praxis

Entzündliche Gelenkerkrankungen – mit Fallbeispielen

Dieses Fachbuch macht mit den wichtigsten chronisch entzündlichen Gelenk- und Wirbelsäulenerkrankungen vertraut. Anhand von über 40 instruktiven Fallbeispielen werden anschaulich diagnostisches Vorgehen, therapeutisches Ansprechen und der Verlauf …

Herausgeber:
Rudolf Puchner

2016 | Buch

Ambulant erworbene Pneumonie

Was, wann, warum – Dieses Buch bietet differenzierte Diagnostik und Therapie der ambulant erworbenen Pneumonie zur sofortigen sicheren Anwendung. Entsprechend der neuesten Studien und Leitlinien aller wichtigen Fachgesellschaften.

Herausgeber:
Santiago Ewig

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Innere Medizin und bleiben Sie gut informiert – ganz bequem per eMail.

© Springer Medizin 

Bildnachweise