Clinical Study
Analysis of early mortality and related risk factors in maintenance hemodialysis patients
Lin Jingjing, Chen Shaohua, Yao Xi, Chen Jianghua, Zhang Ping
Published 2020-08-15
Cite as Chin J Nephrol, 2020, 36(8): 595-600. DOI: 10.3760/cma.j.cn441217-20200312-00108
Abstract
ObjectiveTo analyze the early mortality and related risk factors of new hemodialysis patients in Zhejiang province, and provide basis for reducing the death risk of hemodialysis patients.
MethodsThe early mortality and related factors of new hemodialysis patients from January 1, 2010 to June 30, 2018 were retrospectively analyzed using the database of Zhejiang province hemodialysis registration. The early mortality was defined as death within 90 days of dialysis. Cox regression model was used to analyze the related risk factors of the early mortality in hemodialysis patients.
ResultsThe mortality was the highest in the first month after dialysis (46.40/100 person year), and gradually stabilized after three months. The early mortality was 25.33/100 person year. The mortality within 120 days and 360 days were 21.40/100 person year and 11.37/100 person year, respectively. The elderly (≥65 years old, HR=1.981, 95% CI 1.319-2.977, P<0.001), primary tumor (HR=3.308, 95% CI 1.137-5.624, P=0.028), combined with tumors (not including the primary tumor, HR=2.327, 95%CI 1.200-4.513, P=0.012), temporary catheter (the initial dialysis pathway, HR=3.632, 95% CI 1.806-7.307, P<0.001), lower albumin (<30 g/L,HR=2.181, 95% CI 1.459-3.260, P<0.001), lower hemoglobin (every 0.01 g/L increase,HR=0.861, 95% CI 0.793-0.935, P=0.001), lower high density lipoprotein (<0.7 mmol/L,HR=1.796, 95% CI 1.068-3.019, P=0.027) and higher C reactive protein (≥40 mg/L, HR=1.889, 95% CI 1.185-3.012, P=0.008) were the risk factors of early death for hemodialysis patients.
ConclusionsThe early mortality of hemodialysis patients is high after dialysis, and gradually stable after 3 months. The elderly, primary tumor, combined with tumors, the initial dialysis pathway, lower albumin, lower hemoglobin, lower high density lipoprotein and higher C reactive protein are the risk factors of early death for hemodialysis patients.
Key words:
Renal dialysis; Renal insufficiency; Mortality; End-stage renal disease
Contributor Information
Lin Jingjing
Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310006, China
Chen Shaohua
Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310006, China
Yao Xi
Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310006, China
Chen Jianghua
Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310006, China
Zhang Ping
Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310006, China