Limits...
Survival analysis of patients on maintenance hemodialysis.

Chandrashekar A, Ramakrishnan S, Rangarajan D - Indian J Nephrol (2014)

Bottom Line: On an age-adjusted multivariate analysis, female gender and hypokalemia independently predicted mortality.There was no significant difference between diabetes and non-diabetes in relation to death (Relative Risk = 1.109; 95% CI = 0.49-2.48, P = 0.803).Patient survival was better with higher dialysis dose, increased frequency of dialysis and adequate serum albumin level.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Apollo Hospitals, Bengaluru, Karnataka, India.

ABSTRACT
Despite the continuous improvement of dialysis technology and pharmacological treatment, mortality rates for dialysis patients are still high. A 2-year prospective study was conducted at a tertiary care hospital to determine the factors influencing survival among patients on maintenance hemodialysis. 96 patients with end-stage renal disease surviving more than 3 months on hemodialysis (8-12 h/week) were studied. Follow-up was censored at the time of death or at the end of 2-year study period, whichever occurred first. Of the 96 patients studied (mean age 49.74 ± 14.55 years, 75% male and 44.7% diabetics), 19 died with an estimated mortality rate of 19.8%. On an age-adjusted multivariate analysis, female gender and hypokalemia independently predicted mortality. In Cox analyses, patient survival was associated with delivered dialysis dose (single pool Kt/V, hazard ratio [HR] =0.01, P = 0.016), frequency of hemodialysis (HR = 3.81, P = 0.05) and serum albumin (HR = 0.24, P = 0.005). There was no significant difference between diabetes and non-diabetes in relation to death (Relative Risk = 1.109; 95% CI = 0.49-2.48, P = 0.803). This study revealed that mortality among hemodialysis patients remained high, mostly due to sepsis and ischemic heart disease. Patient survival was better with higher dialysis dose, increased frequency of dialysis and adequate serum albumin level. Efforts at minimizing infectious complications, preventing cardiovascular events and improving nutrition should increase survival among hemodialysis patients.

No MeSH data available.


Related in: MedlinePlus

Native kidney disease
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4119332&req=5

Figure 1: Native kidney disease

Mentions: Majority of the patients were above 40 years (age 49.74 ± 14.55) and males outnumbered females in a ratio of 3:1. Diabetics comprised 44.7% of the patient population and diabetic nephropathy was the most common underlying kidney disease (44.7%). Chronic glomerulonephritis accounted for 23.95% of the cases with varied etiology namely, focal segmental glomerulosclerosis (2.1%), Ig A nephropathy (3.1%) and lupus nephritis (1%) while the cause was undetermined and therefore, presumed in the remaining 17.7% of them based on clinical grounds. Similarly, chronic interstitial nephritis was presumed to be present in 6.3% patients while 2.1% had chronic pyelonephritis. 3 (3.1%) patients with failed renal transplant inducted to hemodialysis were also included in the study with the diagnosis of chronic allograft nephropathy. 15.6% cases had shrunken kidneys precluding histopathological diagnosis and were categorized as unknown group [Table 1, Figure 1].


Survival analysis of patients on maintenance hemodialysis.

Chandrashekar A, Ramakrishnan S, Rangarajan D - Indian J Nephrol (2014)

Native kidney disease
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4119332&req=5

Figure 1: Native kidney disease
Mentions: Majority of the patients were above 40 years (age 49.74 ± 14.55) and males outnumbered females in a ratio of 3:1. Diabetics comprised 44.7% of the patient population and diabetic nephropathy was the most common underlying kidney disease (44.7%). Chronic glomerulonephritis accounted for 23.95% of the cases with varied etiology namely, focal segmental glomerulosclerosis (2.1%), Ig A nephropathy (3.1%) and lupus nephritis (1%) while the cause was undetermined and therefore, presumed in the remaining 17.7% of them based on clinical grounds. Similarly, chronic interstitial nephritis was presumed to be present in 6.3% patients while 2.1% had chronic pyelonephritis. 3 (3.1%) patients with failed renal transplant inducted to hemodialysis were also included in the study with the diagnosis of chronic allograft nephropathy. 15.6% cases had shrunken kidneys precluding histopathological diagnosis and were categorized as unknown group [Table 1, Figure 1].

Bottom Line: On an age-adjusted multivariate analysis, female gender and hypokalemia independently predicted mortality.There was no significant difference between diabetes and non-diabetes in relation to death (Relative Risk = 1.109; 95% CI = 0.49-2.48, P = 0.803).Patient survival was better with higher dialysis dose, increased frequency of dialysis and adequate serum albumin level.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Apollo Hospitals, Bengaluru, Karnataka, India.

ABSTRACT
Despite the continuous improvement of dialysis technology and pharmacological treatment, mortality rates for dialysis patients are still high. A 2-year prospective study was conducted at a tertiary care hospital to determine the factors influencing survival among patients on maintenance hemodialysis. 96 patients with end-stage renal disease surviving more than 3 months on hemodialysis (8-12 h/week) were studied. Follow-up was censored at the time of death or at the end of 2-year study period, whichever occurred first. Of the 96 patients studied (mean age 49.74 ± 14.55 years, 75% male and 44.7% diabetics), 19 died with an estimated mortality rate of 19.8%. On an age-adjusted multivariate analysis, female gender and hypokalemia independently predicted mortality. In Cox analyses, patient survival was associated with delivered dialysis dose (single pool Kt/V, hazard ratio [HR] =0.01, P = 0.016), frequency of hemodialysis (HR = 3.81, P = 0.05) and serum albumin (HR = 0.24, P = 0.005). There was no significant difference between diabetes and non-diabetes in relation to death (Relative Risk = 1.109; 95% CI = 0.49-2.48, P = 0.803). This study revealed that mortality among hemodialysis patients remained high, mostly due to sepsis and ischemic heart disease. Patient survival was better with higher dialysis dose, increased frequency of dialysis and adequate serum albumin level. Efforts at minimizing infectious complications, preventing cardiovascular events and improving nutrition should increase survival among hemodialysis patients.

No MeSH data available.


Related in: MedlinePlus