Causes and risk factors for dropout of nocturnal hemodialysis patients / 第二军医大学学报

ABSTRACT

Objective To explore the causes of nocturnal hemodialysis (NHD) patient dropout and the risk factors for dropout.Methods We collected the clinical data of patients receiving NHD for more than 3 months,of whom 47 patients dropped out and 64 kept receiving NHD from Feb.2009 to Nov.2016 in Changzheng Hospital of Second Military Medical University.We investigated the general conditions;and we compared the differences of the blood parameters between the two groups when the patients received NHD for the first time and for the last time,including hemoglobin,platelet,albumin,ferritin,serum calcium,serum phosphorus and parathyroid hormone.We also analyzed the risk factors for NHD dropout or for death using Cox regression analysis model.Results Among 111 patients,47 patients had withdrawn from NHD,with their average time for NHD being (31.55±20.30) months,and the causes for dropout included death,transferring to other hospitals,turning to conventional hemodialysis (CHD),renal transplantation and others.Univariate Cox regression analysis showed that hypertensive nephropathy (P=0.007,HR=2.913,95％CI1.348-6.293) and diabetic nephropathy (P=0.047,HR=2.401,95％CI1.014-5.685) were risk factors for NHD patient dropout,while chronic nephritis syndrome (P＜0.001,HR=0.095,95％CI 0.046-0.195) was a protective factor;blood albumin (P=0.007,HR=0.904,95％CI0.840-0.973) and age (P=0.027,HR=1.052,95％CI1.006-1.101) were risk factors for NHD patient dropout.Multivariate Cox regression analysis showed that albumin level (P=0.007,HR=0.911,95％CI0.848-0.991) was an independent risk factor for death in NHD patients.Conclusion Hypertensive nephropathy and diabetic nephropathy are the risk factors for NHD patients dropout,while chronic nephritis syndrome was a protective factor.Low serum albumin level is an independent risk faetor for death in NHD patients.