Analysis of Factors Associated with Death in Maintenance Hemodialysis Patients: A Multicenter Study in China.
- Author:
Kang-Kang SONG
1
;
De-Long ZHAO
1
;
Yuan-Da WANG
1
;
Yong WANG
1
;
Xue-Feng SUN
1
;
Li-Ning MIAO
2
;
Zhao-Hui NI
3
;
Hong-Li LIN
4
;
Fu-You LIU
5
;
Ying LI
6
;
Ya-Ni HE
7
;
Nian-Song WANG
8
;
Cai-Li WANG
9
;
Ai-Hua ZHANG
10
;
Meng-Hua CHEN
11
;
Xiao-Ping YANG
12
;
Yue-Yi DENG
13
;
Feng-Min SHAO
14
;
Shu-Xia FU
15
;
Jing-Ai FANG
16
;
Guang-Yan CAI
1
;
Xiang-Mei CHEN
1
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; China; Female; Humans; Male; Middle Aged; Multivariate Analysis; Renal Dialysis; adverse effects; mortality; Retrospective Studies; Risk Factors
- From: Chinese Medical Journal 2017;130(8):885-891
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDPatients on hemodialysis have a high-mortality risk. This study analyzed factors associated with death in patients on maintenance hemodialysis (MHD). While some studies used baseline data of MHD patients, this study used the most recent data obtained from patients just prior to either a primary endpoint or the end of the study period to find the characteristics of patients preceding death.
METHODSParticipants were selected from 16 blood purification centers in China from January 2012 to December 2014. Patients' data were collected retrospectively. Based on survival status, the participants were divided into two groups: survival group and the death group. Logistic regression analysis was performed to determine factors associated with all-cause mortality.
RESULTSIn total, 4104 patients (57.58% male, median age 59 years) were included. Compared with the survival group, the death group had more men and more patients with diabetic nephropathy (DN) and hypertensive nephropathy. The patients preceding death also had lower levels of diastolic blood pressure, hemoglobin, serum albumin, serum calcium, serum phosphate, Kt/V, and higher age. Multivariate analysis revealed that male sex (odd ratio [OR]: 1.437, 95% confidence interval [CI]: 1.094-1.886), age (OR: 1.046, 95% CI: 1.036-1.057), and presence of DN (OR: 1.837, 95% CI: 1.322-2.552) were the risk factors associated with mortality. High serum calcium (OR: 0.585, 95% CI: 0.346-0.989), hemoglobin (OR: 0.974, 95% CI: 0.967-0.981), albumin (OR: 0.939, 95% CI: 0.915-0.963) levels, and dialysis with noncuffed catheter (OR: 0.165, 95% CI: 0.070-0.386) were protective factors based on a multivariate analysis.
CONCLUSIONSHemodialysis patients preceding death had lower hemoglobin, albumin, and serum calcium levels. Multivariate analysis showed that male sex, age, DN, low hemoglobin, low albumin, and low serum calcium were associated with death in hemodialysis patients.