Risk factors for cardiovascular death in urgent-start peritoneal dialysis patients: a multicenter retrospective cohort study

Urgent-start peritoneal dialysis (USPD) has been identified as the efficient approach to initiate renal replacement treatment in end-stage renal disease patients. Cardiovascular mortality of urgent dialysis is an important issue. The present work focused on assessing risk factors related to cardiovascular death in USPD patients. We carried out the present multicenter retrospective cohort study in Northeast China, included adults initiating USPD between 2013 and 2019. Follow-up was conducted in every patient till the occurrence events below: technical failure, death, loss-to-follow-up, and renal transplantation. There were altogether 1549 cases enrolled into this work. Among them, 123 encountered cardiovascular death. Upon multivariate regression, predictors of cardiovascular death included advanced age (HR 1.045, 95% CI [1.031, 1.060]; p < 0.001), higher eGFR (HR 1.084, 95% CI [1.052, 1.117]; p = 0.001), combined with DM (HR 1.471, 95% CI [1.026, 2.110]; p = 0.036), and advanced HF stage (class III versus class 0-I, HR 5.262; 95% CI [3.281, 8.437]; p < 0.001; class IV versus class 0-I, HR 6.409; 95% CI [4.145, 9.912]; p < 0.001). In addition, the predictors of cardiovascular death in diabetic USPD patients included advanced age (HR 1.052, 95% CI [1.027, 1.078]; p < 0.001) and advanced HF stages (class III versus class 0-I, HR 7.843; 95% CI [4.249, 14.476]; p < 0.001; class IV versus class 0-I, HR 5.285; 95% CI [2.880, 9.698]; p < 0.001). Moreover, the predictors of cardiovascular death in elderly USPD patients were advanced age (HR 1.045, 95% CI [1.016, 1.075]; p < 0.001) and advanced HF stages (class III versus class 0-I, HR 3.407; 95% CI [1.911, 6.073]; p < 0.001; class IV versus class 0-I, HR 5.039; 95% CI [2.982, 8.516]; p < 0.001). Risk factors related to cardiovascular death included advanced age, higher eGFR, combined with diabetes, and advanced heart failure stages among USPD patients.