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β-blocker dialyzabi...
β-blocker dialyzability and the risk of mortality and cardiovascular events in patients undergoing hemodialysis
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- Wu, Ping-Hsun (författare)
- Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Internal Med, Div Nephrol, Kaohsiung, Taiwan; Kaohsiung Med Univ, Coll Med, Inst Clin Med, Kaohsiung, Taiwan; Kaohsiung Med Univ, Coll Med, Fac Med, Kaohsiung, Taiwan
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- Lin, Yi-Ting (författare)
- Kaohsiung Med Univ, Coll Med, Inst Clin Med, Kaohsiung, Taiwan; Kaohsiung Med Univ, Coll Med, Fac Med, Kaohsiung, Taiwan; Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Family Med, Kaohsiung, Taiwan
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- Kuo, Mei-Chuan (författare)
- Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Internal Med, Div Nephrol, Kaohsiung, Taiwan; Kaohsiung Med Univ, Coll Med, Fac Med, Kaohsiung, Taiwan; Kaohsiung Med Univ, Coll Med, Fac Renal Care, Kaohsiung, Taiwan
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- Liu, Jia-Sin (författare)
- Kaohsiung Med Univ, Coll Hlth Sci, Grad Inst Publ Hlth, Kaohsiung, Taiwan
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- Tsai, Yi-Chun (författare)
- Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Internal Med, Div Nephrol, Kaohsiung, Taiwan; Kaohsiung Med Univ, Coll Med, Fac Med, Kaohsiung, Taiwan; Kaohsiung Med Univ, Coll Med, Fac Renal Care, Kaohsiung, Taiwan; Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Div Gen Med, Kaohsiung, Taiwan
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- Chiu, Yi-Wen (författare)
- Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Internal Med, Div Nephrol, Kaohsiung, Taiwan; Kaohsiung Med Univ, Coll Med, Fac Med, Kaohsiung, Taiwan; Kaohsiung Med Univ, Coll Med, Fac Renal Care, Kaohsiung, Taiwan
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- Carrero, Juan-Jesus (författare)
- Karolinska Institutet,Uppsala universitet,Institutionen för medicinska vetenskaper,Karolinska Inst, Dept Med Epidemiol & Biostat MEB, Stockholm, Sweden
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(creator_code:org_t)
- 2020-07-28
- 2020
- Engelska.
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Ingår i: Nephrology, Dialysis and Transplantation. - : Oxford University Press (OUP). - 0931-0509 .- 1460-2385. ; 35:11, s. 1959-1965
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Backgroundβ-blocker (BB) dialyzability has been proposed to limit their efficacy among hemodialysis (HD) patients. We attempted to confirm this hypothesis by comparing health outcomes associated with the initiation of dialyzable or nondialyzable BBs in a nationwide cohort of HD patients.MethodsWe created a prospective cohort study of 15 699 HD patients who initiated dialyzable BBs (atenolol, acebutolol, metoprolol and bisoprolol) and 20 904 hemodialysis patients who initiated nondialyzable BBs (betaxolol, carvedilol and propranolol) between 2004 and 2011 in Taiwan healthcare. We compared the risk of all-cause mortality and major adverse cardiovascular events (MACEs, a composite of the acute coronary syndrome, ischemic stroke and heart failure) between users of dialyzable versus nondialyzable BBs during a 2-year follow-up.ResultsNew users of dialyzable BBs were younger, more often men, with diabetes mellitus, hypertension and hyperlipidemia compared with users of nondialyzable BBs. Compared with nondialyzable BBs, initiation of dialyzable BBs was associated with lower all-cause mortality {hazard ratio [HR] 0.82 [95% confidence interval (CI) 0.75–0.88]} and lower risk of MACEs [HR 0.89 (95% CI 0.84–0.93)]. Results were confirmed in subgroup analyses, censoring at BB discontinuation or switch, after 1:1 propensity score matching, reclassifying bisoprolol or excluding bisoprolol/carvedilol users.ConclusionsThis study does not offer support for the hypothesis that the dialyzability of BBs reduces their efficacy in HD patients.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- beta blocker
- cardiovascular event
- dialysis
- mortality
- Taiwan National Health Insurance Research Database
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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