The Causes of Early Death in End-stage Renal Disease Patients.
- Author:
Hyun Yong SONG
1
;
Young Soo PARK
;
Shin Wook KANG
;
Kyu Hun CHOI
;
Sung Kyu HA
;
Dae Suk HAN
;
Ho Yung LEE
Author Information
1. Department of Internal Medicine, College of Medicine, Konyang University, Daejon, Korea.
- Publication Type:Original Article
- Keywords:
End-stage renal disease;
Early death
- MeSH:
C-Reactive Protein;
Cardiovascular Diseases;
Cause of Death;
Diabetes Mellitus;
Dialysis;
Dyslipidemias;
Heart Failure;
Humans;
Hypertension;
Incidence;
Inflammation;
Kidney Failure, Chronic*;
Logistic Models;
Mortality;
Nutritional Status;
Renal Replacement Therapy;
Retrospective Studies;
Risk Factors
- From:Korean Journal of Nephrology
2002;21(4):645-651
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Despite improvements in dialysis care, the mortality of patients with end-stage renal disease(ESRD) remains high. Patients who die within the first 90 days after beginning dialysis are not included in mortality rates and may be absent from incidence count. Therefore, the identification of modifiable characteristics associated with the risk of death during the first 90 days of treatment could lead to improved survival during this interval. METHODS: We performed a retrospective analysis in 986 patients(at least 1 year survival from initiating dialysis were 920 patients, and 66 patients died within 90 days after dialysis) who were initiated renal replacement therapy first at Yonsei Medical Center from Jan 1994 to Jun 1999. RESULTS: The 1 year mortality rate of total patients was 10.4%, and early death rate was 6.9%. The mean survival duration was 28.9+/-23.0 days. Characteristics independently associated with increased risk of early death included older age, inflammation, nutritional impairment, more comorbid condition and previous history of cardiovascular disease at starting dialysis. But Diabetes was not increased early death rate. By multivariate logistic regression analysis, old age, combined comorbid conditions, especially malignancy and congestive heart failure, low serum album and elevated C-reactive protein level were the independent risk factors affecting early death. Other variables such as sex, dyslipidemia, hypertension and diabetes mellitus were not significant risk factors. The leading cause of death in early death group was infection rather than cardiovascular accidents. CONCLUSION: Proper treatment of infection and improved nutritional status by adequate predialytic managements may contribute to their prolonged survival on dialysis patients.
