International Journal of Cardiology 223 (2016) 360

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International Journal of Cardiology

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Correspondence
Risk of hemodialysis against peritoneal dialysis for chronic heart failure in
patients with end-stage renal disease
Tomoyuki Kawada
Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo 113-8602, Japan

a r t i c l e i n f o NT-proBNP, a surrogate marker of CHF, and risk assessment of CHF by

using a biomarker should be considered [4].
Article history:
Wang et al. reported that there was an advantage of PD in patients
Received 9 August 2016
Accepted 11 August 2016
with ESRD to suppress the incident of CHF, especially within 4 years of
Available online 13 August 2016 follow-up [1]. Although I accept their study outcome, there is a fact
that cumulative incidence of CHF exceeds 5% before 4 years of receiving
Keywords: PD. Taken together, there is a need of selecting appropriate dialysis mo-
Hemodialysis
dality to avoid not only CHF but also mortality thereafter.
Peritoneal dialysis
Chronic heart failure
Risk assessment Conflict of interest

The author reports no relationships that could be construed as a con-

flict of interest.

To the Editor,
Wang et al. compared the risk of cardiovascular disease (CVD) be-
tween hemodialysis (HD) and peritoneal dialysis (PD) in patients with
end-stage renal disease (ESRD) [1]. Among 45,309 ESRD patients with-
out preexisting CVD, the authors recruited 6516 patients with HD or PD,
and the Cox proportional hazards regression model was applied to
calculate the risk of HD for new onset CVD, including ischemic heart dis-
ease (IHD) and congestive heart failure (CHF). There was no difference
between HD and PD for the development of IHD, but HD had a 29% in-
crease of CHF than PD with significance. I have a query on their study
with special reference to prognosis thereafter.
The authors recognize the increased risk of mortality in patients
with diabetic ESRD and IHD or CHF [2], and cited a paper by Sens
et al., comparing mortality between PD and HD in patients with ESRD
and CHF [3]. Sens et al. reported that there was a significant difference
in the median survival time of 20.4 months in the PD group and
36.7 months in the HD group with an adjusted hazard ratio of 1.48
and propensity score adjusted hazard ratio of 1.55, respectively. There
is a lack of information on serum brain natriuretic peptide (BNP) or
Acknowledgments
The author wishes to express his appreciation to the members of Hy-
giene and Public Health, Nippon Medical School, for the preparation of
this study. The author of this manuscript has certified that he complies
with the Principles of Ethical Publishing in the International Journal of
Cardiology.
References
[1] I.K. Wang, C.Y. Lu, C.L. Lin, C.C. Liang, T.H. Yen, Y.L. Liu, et al., Comparison of the risk of
de novo cardiovascular disease between hemodialysis and peritoneal dialysis in pa-
tients with end-stage renal disease, Int. J. Cardiol. 208 (2016) 219–224.
[2] I.K. Wang, P.T. Kung, W.Y. Kuo, W.C. Tsai, Y.C. Chang, C.C. Liang, et al., Impact of dial-
ysis modality on the survival of end-stage renal disease patients with or without car-
diovascular disease, J. Nephrol. 26 (2013) 331–341.
[3] F. Sens, A.M. Schott-Pethelaz, M. Labeeuw, C. Colin, E. Villar, REIN Registry, Survival
advantage of hemodialysis relative to peritoneal dialysis in patients with end-stage
renal disease and congestive heart failure, Kidney Int. 80 (2011) 970–977.
[4] R.U. Pliquett, M. Girndt, Hemodialysis vs. peritoneal dialysis in chronic heart failure:
getting to the heart of the matter, Kidney Int. 81 (2012) 1274–1275.

E-mail address: kawada@nms.ac.jp.

http://dx.doi.org/10.1016/j.ijcard.2016.08.217
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