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

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

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

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.

Original languageEnglish
Article number128
JournalBMC Nephrology
Volume18
Issue number1
DOIs
StatePublished - 6 Apr 2017

Keywords

  • Dementia
  • Hemodialysis
  • Ischemic stroke
  • Mortality

Fingerprint

Dive into the research topics of 'Dementia is a risk factor for major adverse cardiac and cerebrovascular events in elderly Korean patients initiating hemodialysis: a Korean national population-based study'. Together they form a unique fingerprint.

Cite this