Analysis of early mortality and related risk factors in maintenance hemodialysis patients / 中华肾脏病杂志

ABSTRACT

Objective:To 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.Methods:The 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.Results:The 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. Conclusions:The 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.