Kidney Res Clin Pract 2019 Dec; 38(4): 490-498  
Dialysis modality-related disparities in sudden cardiac death: hemodialysis versus peritoneal dialysis
Hee-Yeon Jung1 , Hyungyun Choi2 , Ji-Young Choi1 , Jang-Hee Cho1 , Sun-Hee Park1 , Chan-Duck Kim1 , Dong-Ryeol Ryu3,4 , Yong-Lim Kim1; the ESRD Registry Committee of the Korean Society of Nephrology
1Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
2The Korean Society of Nephrology, Seoul, Republic of Korea
3Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
4Tissue Injury Defense Research Center, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
Correspondence to: Yong-Lim Kim
Division of Nephrology, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu 41944, Republic of Korea. E-mail:

Edited by Young-Ki Lee, Hallym University, Seoul, Republic of Korea
Received: March 23, 2019; Revised: July 10, 2019; Accepted: July 19, 2019; Published online: December 31, 2019.
© The Korean Society of Nephrology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Patients require risk stratification and preventive strategies for sudden cardiac death (SCD) based on the dialysis modality because the process of dialysis is a risk factor for SCD. This study aimed to compare the risk of SCD in patients undergoing hemodialysis (HD) versus peritoneal dialysis (PD).
Methods: Patients on HD and PD were included in the end-stage renal disease registry of the Korean Society of Nephrology between 1985 and 2017. The incidence and associated factors of SCD were analyzed based on the dialysis modality.
Results: Of 132,083 patients, 34,632 (26.2%) died during 94.8 ± 73.6 months of follow-up. In patients on HD and PD, 22.2% and 19.6% of total deaths were SCDs. In the propensity score-matched population, SCD accounted for 21.7% and 19.6% of total deaths in patients on HD and PD, respectively. HD was independently associated with SCD even after adjusting for age and significant comorbidities. Hypertension, coronary artery disease, and congestive heart failure, and age at the time of death < 65 years were independent risk factors for SCD in patients on HD but not in those on PD. Diabetes was significantly associated with SCD regardless of the dialysis modality.
Conclusion: Compared with patients on PD, Korean patients on HD have a higher risk of SCD, which is attributable to cardiac comorbidities.
Keywords: Coronary artery disease, Heart failure, Hemodialysis, Hypertension, Peritoneal dialysis, Sudden cardiac death


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