IMR Press / RCM / Volume 24 / Issue 1 / DOI: 10.31083/j.rcm2401030
Open Access Original Research
Preexisting Cardiovascular Disease, Hypertension, and Mortality in Peritoneal Dialysis
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1 Urology & Nephrology Center, Department of Nephrology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), 310014 Hangzhou, Zhejiang, China
2 Department of Nephrology, the First Affiliated Hospital of Nanchang University, 330209 Nanchang, Jiangxi, China
3 Department of Nephrology, the Second Affiliated Hospital of Guangzhou Medical University, 510260 Guangzhou, Guangdong, China
4 Department of Nephrology, the First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, Henan, China
5 Department of Nephrology, Jiujiang No. 1 People's Hospital, 332000 Jiujiang, Jiangxi, China
6 Department of Nephrology, Zhujiang Hospital of Southern Medical University, 510280 Guangzhou, Guangdong, China
7 Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 200233 Shanghai, China
8 Clinical Research Center for Chronic Kidney Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 200233 Shanghai, China
9 Department of Nephrology, Zhejiang University Medical College Affiliated Sir Run Run Shaw Hospital, 310016 Hangzhou, Zhejiang, China
*Correspondence: (Xianfeng Wu); (Junnan Wu)
These authors contributed equally.
Academic Editors: Simonetta Genovesi, Giuseppe Regolisti and Jerome L. Fleg
Rev. Cardiovasc. Med. 2023, 24(1), 30;
Submitted: 21 August 2022 | Revised: 14 November 2022 | Accepted: 15 November 2022 | Published: 16 January 2023
(This article belongs to the Special Issue Coronary Artery Disease in Dialysis Patients)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Preexisting cardiovascular disease (CVD) and hypertension are each associated with poor prognosis in peritoneal dialysis (PD) patients. Joint associations of preexisting CVD and hypertension have not been comprehensively evaluated in this population. Methods: We conducted a retrospective cohort study of 3073 Chinese incident PD patients from five dialysis centres between January 1, 2005, and December 31, 2018. The joint associations between preexisting CVD, hypertension, and mortality were analysed using Cox regression models. Results: Over a median of 33.7 months of follow-up, 581 (18.6%) patients died, with 286 (9.3%) deaths due to CVD. After adjusting for confounding factors, the preexisting CVD coexisting with hypertension, preexisting CVD, and hypertension groups had higher risks of all-cause mortality (hazard ratio [HR]: 3.97, 95% confidence interval [CI]: 3.06 to 5.15; HR: 2.21, 95% CI: 1.29 to 3.79; and HR: 1.83, 95% CI: 1.47 to 2.29, respectively) and CVD mortality (HR: 4.68, 95% CI: 3.27 to 6.69; HR: 2.10, 95% CI: 0.95 to 4.62; and HR: 1.86, 95% CI: 1.36 to 2.54, respectively) than the control group without preexisting CVD or hypertension (p for trend <0.001). There was no interaction between subgroup analyses (p > 0.05). The joint associations showed similar patterns using the Fine–Gray competing risk models. Conclusions: Preexisting CVD and hypertension at the start of PD were additive prognostic utilities for mortality, and preexisting CVD was more strongly associated with mortality than hypertension.

peritoneal dialysis
cardiovascular disease
Fig. 1.
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