β-Blocker Prescription and Outcomes in Hemodialysis Patients from The Japan Dialysis Outcomes and Practice Patterns StudyNakao K.a · Makino H.a · Morita S.b · Takahashi Y.c · Akizawa T.d · Saito A.g · Asano Y.h · Kurokawa K.e · Fukuhara S.b · Akiba T.f
aDepartment of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, bDepartment of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine, Kyoto, cDepartment of Clinical Research and Informatics, International Clinical Research Center, dDepartment of Nephrology, Showa University School of Medicine, eThe Research Center for Advanced Science and Technology, University of Tokyo, and fDepartment of Blood Purification, Tokyo Women’s Medical University, Tokyo, gDepartment of Molecular Nephrology and Bioartificial Organs, Institute of Medical Science, Tokai University, Kanagawa, and hKoga Red Cross Hospital, Ibaraki, Japan
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Background/Aims: Given the clear benefits of mortality reduction observed for most β-blockers in clinical trials, they are relatively underused in hemodialysis patients. Since the outcomes associated with the use of β-blockers are not fully known, we investigated their effect on mortality among a cohort of hemodialysis patients. Methods: Data were analyzed from the Dialysis Outcomes and Practice Patterns Study phase II for 2,286 randomly selected patients on hemodialysis in Japan. Treatment with β-blockers was the major predictor variable. The main outcome measure was all-cause mortality. Cox regression analysis was used to assess an association between treatment with β-blockers and the risk of death. Results: 247 patients (11.9%) were administered β-blockers and 1,828 patients (88.1%) were not. Whereas patients treated with β-blockers had a higher prevalence of hypertension and coronary heart disease, Kaplan-Meier analysis revealed that all-cause mortality rates were significantly (p < 0.007) decreased in patients treated with β-blockers compared to those without. In multivariable, fully adjusted models, treatment with β-blockers was also independently associated with reduced all-cause mortality (hazard ratio = 0.48; p = 0.02). Conclusion: This study indicated a possible association between the use of β-blockers and reduced risk of mortality in hemodialysis patients. These results should be confirmed in further randomized controlled trials.
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