Beta-Blocker dialyzability and mortality in older patients receiving hemodialysis

Matthew A Weir, Stephanie N Dixon, Jamie L Fleet, Matthew Allan Roberts, Daniel G Hackam, Matthew J Oliver, Rita S Suri, Robert R Quinn, Sundus Ozair, Michael Beyea, Abhijat Kitchlu, Amit X Garg

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58 Citations (Scopus)

Abstract

Some beta-blockers are efficiently removed from the circulation by hemodialysis ( high dialyzability ) whereas others are not ( low dialyzability ). This characteristic may influence the effectiveness of the ?-blockers among patients receiving long-term hemodialysis. To determine whether new use of a high-dialyzability ?-blocker compared with a low-dialyzability ?-blocker associates with a higher rate of mortality in patients older than age 66 years receiving long-term hemodialysis, we conducted a propensity-matched population-based retrospective cohort study using the linked healthcare databases of Ontario, Canada. The high-dialyzability group (n=3294) included patients initiating atenolol, acebutolol, or metoprolol. The low-dialyzability group (n=3294) included patients initiating bisoprolol or propranolol. Initiation of a high-versus low-dialyzability ?-blocker was associated with a higher risk of death in the following 180 days (relative risk, 1.4; 95 confidence interval, 1.1 to 1.8; P
Original languageEnglish
Pages (from-to)987 - 996
Number of pages10
JournalJournal of the American Society of Nephrology
Volume26
Issue number4
DOIs
Publication statusPublished - 2015

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