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논문 기본 정보

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학술저널
저자정보
Kang Yeunmi (Ewha Womans University Mokdong Hospital) 최현경 (동아대학교) 권영은 (서남대학교) Shin Ji Hyeon (Hanyang University College of Medicine) Won Eun Mi (Health Insurance Review and Assessment Service Wonju Republic of Korea) Yang Ki Hwa (Health Insurance Review and Assessment Service Wonju Korea.) Oh Hyung Jung (Ewha Womans University Mokdong Hospital) Ryu Dong-Ryeol (Ewha Womans University Mokdong Hospital)
저널정보
대한신장학회 Kidney Research and Clinical Practice Kidney Research and Clinical Practice Vol.40 No.1
발행연도
2021.1
수록면
99 - 108 (10page)

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Background: The number of patients requiring dialysis is increasing worldwide, and the atrial fibrillation and atrial flutter (AF) prevalence among hemodialysis (HD) patients is higher than in the general population. There have been no studies of Korean AF patients undergoing HD that investigated how AF affects outcomes, such as all-cause mortality, hospitalization, and stroke events. We conducted a large-scale retrospective cohort study with data from the National Health Insurance System to determine how AF affects these outcomes. Methods: In 2013, the Health Insurance Review and Assessment service, a Korean national health insurance scheme, collected data from 21,839 HD patients to evaluate the adequacy of dialysis centers. All-cause mortality, hospitalization, and stroke events were compared between patients with and without AF. Sub-analyses compared these outcomes between AF patients receiving warfarin and those not receiving warfarin. Results: Cox regression analysis found that AF was a significant risk factor for death from any cause (hazard ratio [HR], 1.356; 95% confidence interval [CI], 1.222–1.506; p < 0.001), hospitalization (HR, 1.323; 95% CI, 1.225–1.430; p < 0.001), and hemorrhagic stroke (HR, 1.500; 95% CI, 1.050–2.141; p = 0.026). AF was not significantly associated with an increased risk of ischemic stroke. The use of warfarin was significantly associated with hemorrhagic stroke incidence (HR, 1.593; 95% CI, 1.075–2.360; p = 0.020), while there was no significant correlation between warfarin treatment and all-cause mortality, hospitalization, and ischemic stroke. Conclusion: This cohort study of Korean dialysis patients showed that AF was a risk factor for multiple outcomes among HD patients.

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