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

Cumulative patient survival and dialysis dose (Kt/V)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Cumulative patient survival and dialysis dose (Kt/V)

Mentions: Among the variables included for assessing survival functions using Cox-regression model, dialysis dose delivered (spKt/V), frequency of hemodialysis and the level of serum albumin were found to be significantly affecting the survival [Table 6]. The patients who received a higher dose of dialysis (Kt/V >1.2) had a survival advantage over those with lesser delivered dose of dialysis (Kt/V < 1.2). This was statistically significant (Hazard Ratio [HR] 0.01, P = 0.016). Similarly, those who underwent twice weekly hemodialysis had 3.81 times lesser chances of survival when compared to those with thrice weekly dialysis (P = 0.05). Serum albumin level >4 g/dl was associated with better survival (HR 0.24, P = 0.005). Though the proportion of patients with diabetes mellitus was large, there was no significant difference between those with and without diabetes in relation to survival [Figures 3-6].


Survival analysis of patients on maintenance hemodialysis.

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

Cumulative patient survival and dialysis dose (Kt/V)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Cumulative patient survival and dialysis dose (Kt/V)
Mentions: Among the variables included for assessing survival functions using Cox-regression model, dialysis dose delivered (spKt/V), frequency of hemodialysis and the level of serum albumin were found to be significantly affecting the survival [Table 6]. The patients who received a higher dose of dialysis (Kt/V >1.2) had a survival advantage over those with lesser delivered dose of dialysis (Kt/V < 1.2). This was statistically significant (Hazard Ratio [HR] 0.01, P = 0.016). Similarly, those who underwent twice weekly hemodialysis had 3.81 times lesser chances of survival when compared to those with thrice weekly dialysis (P = 0.05). Serum albumin level >4 g/dl was associated with better survival (HR 0.24, P = 0.005). Though the proportion of patients with diabetes mellitus was large, there was no significant difference between those with and without diabetes in relation to survival [Figures 3-6].

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