Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes: A Nationwide Study From 2002 to 2016
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 Patien...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.032539 |
| _version_ | 1797257407127093248 |
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| author | Pauline Knigge Sørine Lundberg Jarl E. Strange Mariam E. Malik Nina Nouhravesh Andrea K. Wagner Gunnar Gislason Emil L. Fosbøl Nicholas Carlson Deewa Zahir Charlotte Andersson Jawad H. Butt Pardeep Jhund Mark C. Petrie John J. V. McMurray Lars Køber Morten Schou |
| author_facet | Pauline Knigge Sørine Lundberg Jarl E. Strange Mariam E. Malik Nina Nouhravesh Andrea K. Wagner Gunnar Gislason Emil L. Fosbøl Nicholas Carlson Deewa Zahir Charlotte Andersson Jawad H. Butt Pardeep Jhund Mark C. Petrie John J. V. McMurray Lars Køber Morten Schou |
| author_sort | Pauline Knigge |
| collection | DOAJ |
| description | 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 calculated 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, respectively, 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. |
| first_indexed | 2024-04-24T22:37:09Z |
| format | Article |
| id | doaj.art-b23f4c07f3714d46b62dc9fc1e7a620e |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T22:37:09Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-b23f4c07f3714d46b62dc9fc1e7a620e2024-03-19T10:07:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-03-0113610.1161/JAHA.123.032539Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes: A Nationwide Study From 2002 to 2016Pauline Knigge0Sørine Lundberg1Jarl E. Strange2Mariam E. Malik3Nina Nouhravesh4Andrea K. Wagner5Gunnar Gislason6Emil L. Fosbøl7Nicholas Carlson8Deewa Zahir9Charlotte Andersson10Jawad H. Butt11Pardeep Jhund12Mark C. Petrie13John J. V. McMurray14Lars Køber15Morten Schou16Department of Cardiology Herlev‐Gentofte University Hospital Hellerup DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Hellerup DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Hellerup DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Hellerup DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Hellerup DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Hellerup DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Hellerup DenmarkDepartment of Cardiology Rigshospitalet, Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology Rigshospitalet, Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Hellerup DenmarkBrigham and Women’s Hospital Heart and Vascular Center Boston MA USADepartment of Cardiology Herlev‐Gentofte University Hospital Hellerup DenmarkBritish Heart Foundation Cardiovascular Research Centre University of Glasgow Glasgow United KingdomBritish Heart Foundation Cardiovascular Research Centre University of Glasgow Glasgow United KingdomBritish Heart Foundation Cardiovascular Research Centre University of Glasgow Glasgow United KingdomDepartment of Cardiology Rigshospitalet, Copenhagen University Hospital Copenhagen DenmarkDepartment of Cardiology Herlev‐Gentofte University Hospital Hellerup DenmarkBackground 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 calculated 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, respectively, 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.https://www.ahajournals.org/doi/10.1161/JAHA.123.032539acute dialysischronic dialysisdiabetesepidemiologyheart failurehospitalization due to heart failure |
| spellingShingle | Pauline Knigge Sørine Lundberg Jarl E. Strange Mariam E. Malik Nina Nouhravesh Andrea K. Wagner Gunnar Gislason Emil L. Fosbøl Nicholas Carlson Deewa Zahir Charlotte Andersson Jawad H. Butt Pardeep Jhund Mark C. Petrie John J. V. McMurray Lars Køber Morten Schou Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes: A Nationwide Study From 2002 to 2016 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute dialysis chronic dialysis diabetes epidemiology heart failure hospitalization due to heart failure |
| title | Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes: A Nationwide Study From 2002 to 2016 |
| title_full | Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes: A Nationwide Study From 2002 to 2016 |
| title_fullStr | Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes: A Nationwide Study From 2002 to 2016 |
| title_full_unstemmed | Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes: A Nationwide Study From 2002 to 2016 |
| title_short | Temporal Trends in the Initiation of Dialysis Among Patients With Heart Failure With or Without Diabetes: A Nationwide Study From 2002 to 2016 |
| title_sort | temporal trends in the initiation of dialysis among patients with heart failure with or without diabetes a nationwide study from 2002 to 2016 |
| topic | acute dialysis chronic dialysis diabetes epidemiology heart failure hospitalization due to heart failure |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.032539 |
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