Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes: A Nationwide Study From 2002 to 2016
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes : A Nationwide Study From 2002 to 2016. / Knigge, Pauline; Lundberg, Sørine; Strange, Jarl E.; Malik, Mariam E.; Nouhravesh, Nina; Wagner, Andrea K.; Gislason, Gunnar; Fosbøl, Emil L.; Carlson, Nicholas; Zahir, Deewa; Andersson, Charlotte; Butt, Jawad H.; Jhund, Pardeep; Petrie, Mark C.; McMurray, John J.V.; Køber, Lars; Schou, Morten.
In: Journal of the American Heart Association, Vol. 13, No. 6, e032539, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes
T2 - A Nationwide Study From 2002 to 2016
AU - Knigge, Pauline
AU - Lundberg, Sørine
AU - Strange, Jarl E.
AU - Malik, Mariam E.
AU - Nouhravesh, Nina
AU - Wagner, Andrea K.
AU - Gislason, Gunnar
AU - Fosbøl, Emil L.
AU - Carlson, Nicholas
AU - Zahir, Deewa
AU - Andersson, Charlotte
AU - Butt, Jawad H.
AU - Jhund, Pardeep
AU - Petrie, Mark C.
AU - McMurray, John J.V.
AU - Køber, Lars
AU - Schou, Morten
N1 - Publisher Copyright: © 2024 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2024
Y1 - 2024
N2 - BACKGROUND: The incidence and distribution of acute and chronic dialysis among patients with heart failure (HF), stratified by diabetes, remain uncertain. We hypothesized that with improved survival and rising comorbidities, the demand for dialysis would increase over time. METHODS AND RESULTS: Patients with incident HF, aged 18 to 100 years, between 2002 and 2016, were identified using Danish nationwide registers. Primary outcomes included acute and chronic dialysis initiation, HF-related hospitalization, and all-cause mortality. These outcomes were assessed in 2002 to 2006, 2007 to 2011, and 2012 to 2016, stratified by diabetes. We cal-culated incidence rates (IRs) per 1000 person-years and hazard ratios (HR) using multivariable Cox regression. Of 115 533 patients with HF, 2734 patients received acute dialysis and 1193 patients received chronic dialysis. The IR was 8.0 per 1000 and 3.5 per 1000 person-years for acute and chronic dialysis, respectively. Acute dialysis rates increased significantly among patients with diabetes over time, while no significant changes occurred in those without diabetes, chronic dialysis, HF-related hospitalization, or overall mortality. Diabetes was associated with significantly higher HRs of acute and chronic dialysis, re-spectively, compared with patients without diabetes (HR, 2.07 [95% CI, 1.80–2.39] and 2.93 [95% CI, 2.40–3.58] in 2002 to 2006; HR, 2.45 [95% CI, 2.14–2.80] and 2.86 [95% CI, 2.32–3.52] in 2007 to 2011; and 2.69 [95% CI, 2.33–3.10] and 3.30 [95% CI, 2.69–4.06] in 2012 to 2016). CONCLUSIONS: The IR of acute and chronic dialysis remained low compared with HF-related hospitalizations and mortality. Acute dialysis rates increased significantly over time, contrasting no significant trends in other outcomes. Diabetes exhibited over 2-fold increased rates of the outcomes. These findings emphasize the importance of continued monitoring and renal care in patients with HF, especially with diabetes, to optimize outcomes and prevent adverse events.
AB - BACKGROUND: The incidence and distribution of acute and chronic dialysis among patients with heart failure (HF), stratified by diabetes, remain uncertain. We hypothesized that with improved survival and rising comorbidities, the demand for dialysis would increase over time. METHODS AND RESULTS: Patients with incident HF, aged 18 to 100 years, between 2002 and 2016, were identified using Danish nationwide registers. Primary outcomes included acute and chronic dialysis initiation, HF-related hospitalization, and all-cause mortality. These outcomes were assessed in 2002 to 2006, 2007 to 2011, and 2012 to 2016, stratified by diabetes. We cal-culated incidence rates (IRs) per 1000 person-years and hazard ratios (HR) using multivariable Cox regression. Of 115 533 patients with HF, 2734 patients received acute dialysis and 1193 patients received chronic dialysis. The IR was 8.0 per 1000 and 3.5 per 1000 person-years for acute and chronic dialysis, respectively. Acute dialysis rates increased significantly among patients with diabetes over time, while no significant changes occurred in those without diabetes, chronic dialysis, HF-related hospitalization, or overall mortality. Diabetes was associated with significantly higher HRs of acute and chronic dialysis, re-spectively, compared with patients without diabetes (HR, 2.07 [95% CI, 1.80–2.39] and 2.93 [95% CI, 2.40–3.58] in 2002 to 2006; HR, 2.45 [95% CI, 2.14–2.80] and 2.86 [95% CI, 2.32–3.52] in 2007 to 2011; and 2.69 [95% CI, 2.33–3.10] and 3.30 [95% CI, 2.69–4.06] in 2012 to 2016). CONCLUSIONS: The IR of acute and chronic dialysis remained low compared with HF-related hospitalizations and mortality. Acute dialysis rates increased significantly over time, contrasting no significant trends in other outcomes. Diabetes exhibited over 2-fold increased rates of the outcomes. These findings emphasize the importance of continued monitoring and renal care in patients with HF, especially with diabetes, to optimize outcomes and prevent adverse events.
KW - acute dialysis
KW - chronic dialysis
KW - diabetes
KW - epidemiology
KW - heart failure
KW - hospitalization due to heart failure
U2 - 10.1161/JAHA.123.032539
DO - 10.1161/JAHA.123.032539
M3 - Journal article
C2 - 38471834
AN - SCOPUS:85188480234
VL - 13
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 6
M1 - e032539
ER -
ID: 388870553