Predictors of mortality in hemodialysis patients

Pan Afr Med J. 2019 May 28:33:61. doi: 10.11604/pamj.2019.33.61.18083. eCollection 2019.

Abstract

Introduction: Mortality in patients with chronic renal failure is high compared to the general population. The objective of our study is to evaluate the predictive factors related to mortality in hemodialysis.

Methods: This is a retrospective study involving 126 hemodialysis patients in the Nephrology Department of Ibn Rochd Hospital, Casablanca. Data were collected between January 2012 and January 2016. For each of our patients, we analyzed demographic, clinical, biological and anthropometric data. The Kaplan-Meier method and the log-rank test were used to evaluate and compare survival curves. To evaluate the effect of predictors of mortality, we used the proportional Cox hazard model.

Results: The analysis of the results showed that the surviving patients were younger than the deceased patients (43.07±13.52 years versus 53.09±13.56 years, p=0.001). Also, the latter has a significantly lower albumin and prealbumin levels (p=0.01 and p=0.04 respectively). Overall survival was 80.2%. Cox regression analysis at age (HR=1.26, p<0.0002), inflammation (HR=1.15, p<0.03), AIP> 0.24 (HR=2.1, p<0.002) and cardiovascular disease (RR=2.91, p<0.001) were associated with global and cardiovascular mortality.

Conclusion: Our study showed that the mortality rate is high in our cohort. In addition, cardiovascular diseases, under nutrition and inflammation are predictive factors for mortality. Treatment and early management of these factors are essential for reducing morbidity and mortality.

Keywords: Mortality; and chronic renal failure; cardiovascular diseases; under nutrition.

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality*
  • Cohort Studies
  • Female
  • Humans
  • Inflammation / epidemiology
  • Inflammation / mortality
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / therapy*
  • Male
  • Malnutrition / epidemiology
  • Malnutrition / mortality
  • Middle Aged
  • Morocco
  • Proportional Hazards Models
  • Renal Dialysis / methods*
  • Retrospective Studies
  • Risk Factors