Effects of β-blockers therapy on the 28-day and 3-year survival rates of end-stage renal disease patients with cardiovascular disease: a retrospective cohort study

Yong Wang; Zheqian Wu; Shijie Lu; Lili Yin; Yuandong Chen; Canyi Qiu; Pauline Yeung Ng; Koray Durak; Cristian Deana; Fei Ding; Zhiyan Zhang; Lihua Dai

doi:10.21037/atm-22-5317

Effects of β-blockers therapy on the 28-day and 3-year survival rates of end-stage renal disease patients with cardiovascular disease: a retrospective cohort study

Ann Transl Med. 2022 Nov;10(22):1234. doi: 10.21037/atm-22-5317.

Authors

Yong Wang¹, Zheqian Wu¹, Shijie Lu¹, Lili Yin¹, Yuandong Chen¹, Canyi Qiu¹, Pauline Yeung Ng^{2

3}, Koray Durak^{4

5}, Cristian Deana⁶, Fei Ding¹, Zhiyan Zhang¹, Lihua Dai¹

Affiliations

¹ Department of Emergency, Shidong Hospital, Yangpu District, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, Shanghai, China.
² Critical Care Medicine Unit, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China.
³ Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong, China.
⁴ Department of Thoracic Surgery, RWTH University Hospital, Aachen, Germany.
⁵ Radboud University Medical Center, Nijmegen, The Netherlands.
⁶ Department of Anesthesia and Intensive Care, ASUFC-Academic Hospital of Udine, Udine, Italy.

Abstract

Background: β-blockers have been used in the treatment of end-stage renal disease (ESRD) patients and cardiovascular disease (CVD) patients, separately. However, the effects of β-blockers on ESRD patients with CVD have not been fully investigated. This study sought to investigate the effects of β-blockers therapy on the 28-day and 3-year survival rates of ESRD patients with pre-existing CVD who were admitted to the intensive care unit (ICU).

Methods: After excluding patients without CVD, receiving a kidney transplant, not admitted to the ICU, and with missing baseline data, this cohort study included 1081 ESRD participants with CVD from the Medical Information Mark for Intensive Care III database. Baseline characteristics, including demographic data and clinical data, were collected. The outcomes were 28-day and 3-year survival rates of the patients. At the 28-day of ICU hospitalization, patients had a mean inpatient hospital stay of 24.7 days. At 3-year, the patients had a median survival time of 489.2 days. Univariate and multivariate Cox regression analyses were used to evaluate the effects of β-blockers therapy on the 28-day and 3-year survival outcomes of ESRD patients with CVD.

Results: The 28-day and 3-year survival rates were 82.8% and 37.9%, respectively. The mean age of the all patients was 68 years, and 642 were male. After adjusting for age, race, hyperlipidemia, dialysis, simplified acute physiological score (SAPS) II, sequential organ failure assessment (SOFA) score, glucocorticoid, hemoglobin, diabetes, hypertension, the 28-day survival rate of the ESRD patients with CVD requiring intensive care who received β-blockers therapy was higher than that of the patients who did not receive the treatment. Similarly, after adjusting for age, race, hyperlipidemia, dialysis, SAPS II, SOFA score, glucocorticoid, hemoglobin, diabetes, hypertension, creatinine, the long-term survival rate of the patients who received β-blockers therapy was also higher than that of those who did not.

Conclusions: β-blockers therapy was associated with increased 28-day and 3-year survival rates in ESRD patients with CVD requiring intensive care. Our findings may provide a theoretical basis for the prognostic impact of β-blockers therapy among patients with ESRD and CVD who were admitted to the ICU.

Keywords: 28-day survival; 3-year survival; End-stage renal disease (ESRD); cardiovascular disease (CVD); β-blocker.