Mesenteric ischemia in patients with end-stage renal disease: A nationwide longitudinal study

Szu Yuan Li, Yung Tai Chen, Tzeng Ji Chen, Lung Wen Tsai, Wu Chang Yang, Tzen Wen Chen

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background and Aims: Mesenteric ischemia is an uncommon disorder associated with an extremely high mortality rate. Only limited studies have evaluated this lethal disease among patients with end-stage renal disease (ESRD). The objective of this study was to evaluate the risks of mesenteric ischemia among ESRD patients and compare the incidence between two dialysis modalities. Methods: Records of all ESRD patients older than 20 years of age from 1998 to 2007 and a control group consisting of 1 million records were retrieved from the Taiwan National Health Insurance Research Database. Hospitalizations for mesenteric ischemic events were retrieved using ICD-9-CM diagnosis codes and ICD-9-CM operation codes from inpatient claims. Results: Among 55,807 incident ESRD patients who received hemodialysis or peritoneal dialysis, there were 458 mesenteric ischemic events, corresponding to an incidence rate of 2.7 per 1,000 patient-years. Multivariate Cox regression analysis indicated that the independent risk factors were old age (HR 1.42 per 10 years), diabetes (HR 2.85), peripheral vascular disease (HR 2.66), atrial fibrillation (HR 2.15), heart failure (HR 1.65), chronic pulmonary disease (HR 1.41), neoplasm (HR 1.54), peptic ulcer disease (HR 1.86), and peritoneal dialysis (HR 1.51, all p <0.05). There was no effect of dialysis modality on the mesenteric ischemia mortality rate. Conclusion: The risk of mesenteric ischemia for ESRD patients was 44.1 (95% confidence interval 13.4-106.2, p <0.001) times higher than that of the general population. Compared to hemodialysis, peritoneal dialysis was associated with a higher risk of mesenteric ischemia.

Original languageEnglish
Pages (from-to)491-497
Number of pages7
JournalAmerican Journal of Nephrology
Volume35
Issue number6
DOIs
Publication statusPublished - Jun 2012

Keywords

  • End-stage renal disease
  • Mesenteric ischemia
  • Renal replacement therapy
  • Taiwan National Health Insurance Research Database

ASJC Scopus subject areas

  • Nephrology

Fingerprint Dive into the research topics of 'Mesenteric ischemia in patients with end-stage renal disease: A nationwide longitudinal study'. Together they form a unique fingerprint.

  • Cite this

    Li, S. Y., Chen, Y. T., Chen, T. J., Tsai, L. W., Yang, W. C., & Chen, T. W. (2012). Mesenteric ischemia in patients with end-stage renal disease: A nationwide longitudinal study. American Journal of Nephrology, 35(6), 491-497. https://doi.org/10.1159/000338451