The predictors of early mortality in patients starting chronic hemodialysis.

ABSTRACT

To evaluate the predictors of early mortality in patients on chronic hemodialysis, we reviewed the records of 192 patients starting chronic hemodialysis at our centre between January 1996 and September 1999. The overall incident mortality within 90 days was 32 (16.7%) patients. The cardiovascular causes accounted for 50% of all the causes of mortality. By using multivariate stepwise logistic regression analysis, early mortality rate was not significantly increased in the comparison of age or gender groups but increased in patients with diabetes mellitus, as well as those with reduced dialysis frequency. The most powerful predictor of survival was serum albumin level of less than 30 g/l. Thus, the survival rates in patients with serum albumin less than 30 g/l and those with serum albumin equal to or greater than 30 g/l were 67.8% and 90.2%, respectively, (p< 0.001). The odds ratio was 4.68. We conclude that these findings suggest that the important predictors of early mortality in the first 90 days of starting hemodialysis include the presence of diabetes mellitus, the decreased frequency of dialysis sessions and the presence of low serum albumin. The low serum albumin below 30 g/l was the strongest predictor of early mortality.