title: Increased risk of hydrocephalus in long-term dialysis patients.
abstract: The risk of hydrocephalus in end-stage renal disease (ESRD) patients on dialysis has not been studied in depth.
  
  
  
  Using Taiwan National Health Insurance claims data, we identified 29 684 incident ESRD patients from 2000 to 2010, including 10 030 peritoneal dialysis (PD) patients and 19 654 hemodialysis (HD) patients. The control cohort consisted of 118 736 people randomly selected from those without kidney disease, frequency matched with ESRD patients by age, sex and index year. We also established propensity score-matched cohorts with 10 014 PD and 10 014 HD patients. The incidence rates and hazard ratios (HRs) of hydrocephalus were calculated until the end of 2011.
  
  
  
  Incidence rates of hydrocephalus were greater in HD and PD patients than in controls (8.44 and 11.0 versus 4.11 per 10 000 person-years, respectively), with an adjusted HR of 1.86 [95% confidence interval (CI) 1.43-2.41] for all ESRD patients compared with controls. A higher proportion of hydrocephalus patients underwent surgical bypass to relieve hydrocephalus in ESRD patients than controls, 40.7% (46/113) versus 24.5% (67/273), with an adjusted odds ratio of 2.11 (95% CI 1.33-3.36). Compared with controls, the adjusted HRs of communicating hydrocephalus for HD and PD patients were 1.77 (95% CI 1.22-2.55) and 2.51 (95% CI 1.61-3.89), respectively. The propensity score-matched analysis showed an HR of 0.72 (95% CI 0.42-1.23) for hydrocephalus in HD patients compared with PD patients.
  
  
  
  Patients with ESRD are at an increased risk of hydrocephalus. The risk difference between HD and PD patients is not significant.
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan.
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Division of Neurosurgery, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Yu-Kai
authors.initials: YK
authors.lastname: Cheng
authors.affiliation: Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Chou
authors.affiliation: Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chih-Chia
authors.initials: CC
authors.lastname: Liang
authors.affiliation: Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Tzung-Hai
authors.initials: TH
authors.lastname: Yen
authors.affiliation: Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan Department of Health Services Administration, China Medical University, Taichung, Taiwan Mahidol University Faculty of Public Health, Bangkok, Thailand.
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000453:epidemiology / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D015995:Prevalence; D057216:Propensity Score; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: cohort study; end-stage renal disease; hydrocephalus