title: Risk of major cardiovascular events among incident dialysis patients: A Korean national population-based study.
abstract: BACKGROUND
  Dialysis patients are at high risk for cardiovascular diseases, but until now there have been no detailed analyses of the incidences among Asian patients initiating dialysis. The aims of this study were to determine the incidence rates of major adverse cardiac and cerebrovascular events (MACCE) and to compare them between incident HD patients and PD patients.
  
  
  METHODS
  We included all patients who had started dialysis between January 1, 2005 and December 31, 2008 in Korea, and analyzed 30,279 eligible patients [22,892 hemodialysis (HD) patients and 7387 peritoneal dialysis (PD) patients] by intention-to-treat. Median follow-up was 21.5 months.
  
  
  RESULTS
  The crude incidence rates were as follows: MACCE, 182 per 1000 patient-years (PY); major adverse cardiac events (MACE), 138/1000 PY; all-cause mortality, 116/1000 PY; non-fatal acute myocardial infarction (AMI), 18/1000 PY; target vessel revascularization (TVR), 17/1000 PY; and non-fatal stroke, 60/1000 PY. When comparing all baseline covariate-adjusted relative risks between HD and PD patients, HD is overall superior to PD in terms of MACCE. Further examined by each endpoint, all-cause mortality, non-fatal AMI, and TVR occurred significantly more frequently in patients on PD than in those on HD, whereas non-fatal hemorrhagic stroke occurred significantly more frequently in patients on HD than in those on PD.
  
  
  CONCLUSIONS
  The incidence of MACCE may be different from Western dialysis patients. HD is overall superior to PD in terms of MACCE as an initial dialysis modality. Underlying mechanisms differentially affecting cardiovascular outcomes by dialysis modality remain to be further elucidated.
authors.affiliation: Department of Internal Medicine, Wonkwang University College of Medicine Sanbon Hospital, Gunpo, Republic of Korea.
authors.forename: Hyunwook
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Public Health, Graduate School, Korea University, Seoul, Republic of Korea.
authors.forename: Kyoung Hoon
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
authors.forename: Song Vogue
authors.initials: SV
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea.
authors.forename: Shin-Wook
authors.initials: SW
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea.
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yoo
authors.affiliation: Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea.
authors.forename: Hyeong Sik
authors.initials: HS
authors.lastname: Ahn
authors.affiliation: Ewha Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: Hoo Jae
authors.initials: HJ
authors.lastname: Hann
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: Shina
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: Jung-Hwa
authors.initials: JH
authors.lastname: Ryu
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: Mina
authors.initials: M
authors.lastname: Yu
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: Duk-Hee
authors.initials: DH
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
authors.forename: Kyu Bok
authors.initials: KB
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea. Electronic address: drryu@ewha.ac.kr.
authors.forename: Dong-Ryeol
authors.initials: DR
authors.lastname: Ryu
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000401:mortality / Q000639:trends; D011159:Population Surveillance; D012042:Registries; D006435:Renal Dialysis / Q000401:mortality* / Q000639:trends; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
keywords: Cardiovascular disease; Hemodialysis; Peritoneal dialysis