title: Hemodialysis Is Associated With Increased Peripheral Artery Occlusive Disease Risk Among Patients With End-Stage Renal Disease: A Nationwide Population-Based Cohort Study.
abstract: To investigate the effect of different dialysis modalities on the incidence of peripheral artery occlusive disease (PAOD) among patients with end-stage renal disease (ESRD) in a large population-based cohort study. The cohort study included 26,927 ESRD patients who underwent hemodialysis (17,737 patients, hemodialysis [HD] cohort) or peritoneal dialysis (PD, 9190 patients, PD cohort), and 107,588 matched controls between 2000 and 2010. A Cox proportional hazards model was to evaluate the risk of PAOD in the ESRD underwent HD or PD. Based on a mean follow-up period of 2.92, 3.64, and 4.91 years in the PD, HD, and control cohorts, respectively, the incidences of PAOD were 18.1% and 8.10% higher in the HD and PD cohorts, respectively, compared with the control cohort (log-rank test P < 0.001). The patients who underwent HD or PD exhibited a higher risk of PAOD compared with the control cohort regardless of age, sex, and presence or absence of comorbidities. In addition, the incidence of PAOD in the PD cohort and the propensity score-matched HD cohort were 12.4 and 20.7 per 1000 person-years, respectively, with a hazard ratio of 1.92 (95% confidence interval = 1.62-2.28) in HD patients, compared with the PD cohort. This nationwide population-based cohort study suggested a significantly increased risk of PAOD among ESRD patients. Moreover, the PD patients have a lower risk of developing PAOD compared with the HD cohort, indicating the beneficial roles of PD in reducing PAOD risk in ESRD patients.
authors.affiliation: From the Division of Cardiology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (C-SL, S-MC); Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (S-JC); Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (C-CS, S-HL); Management Office for Health Data, China Medical University Hospital (C-LL); College of Medicine, China Medical University (C-LL); Graduate Institute of Clinical Medical Science and School of Medicine (I-KW, C-HK); Department of Internal Medicine, College of Medicine, China Medical University (I-KW); Division of Kidney Disease, China Medical University Hospital, Taichung (I-KW); Department of Nuclear Medicine, Changhua Christian Hospital, Changhua (W-SH); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).
authors.forename: Chin-Sheng
authors.initials: CS
authors.lastname: Lin
authors.forename: Sy-Jou
authors.initials: SJ
authors.lastname: Chen
authors.forename: Chih-Chien
authors.initials: CC
authors.lastname: Sung
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Shih-Hua
authors.initials: SH
authors.lastname: Lin
authors.forename: Shu-Meng
authors.initials: SM
authors.lastname: Cheng
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Huang
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D001157:Arterial Occlusive Diseases / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology* / Q000209:etiology; D010530:Peritoneal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology