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

Title
Dementia is a risk factor for major adverse cardiac and cerebrovascular events in elderly Korean patients initiating hemodialysis: a Korean national population-based study
Authors
Jung, Sung MinKim, Clara TammyKang, Ea WhaKim, Kyoung HoonLee, ShinaOh, Hyung JungKim, Seung-JungKang, Duk-HeeChoi, Kyu BokRyu, Dong-RyeolKim, Hyunwook
Ewha Authors
정성민강덕희최규복류동열이신아오형중
SCOPUS Author ID
정성민scopus; 강덕희scopus; 최규복scopus; 류동열scopus; 이신아scopusscopus; 오형중scopus
Issue Date
2017
Journal Title
BMC NEPHROLOGY
ISSN
1471-2369JCR Link
Citation
vol. 18
Keywords
DementiaHemodialysisMortalityIschemic stroke
Publisher
BIOMED CENTRAL LTD
Indexed
SCIE; SCOPUS WOS scopus
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.
DOI
10.1186/s12882-017-0547-0
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의학전문대학원 > 의학과 > Journal papers
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