Prediction model for 6-month mortality in incident older hemodialysis patients in South Korea
10.23876/j.krcp.23.224
- Author:
Woo Yeong PARK
;
Eunjin BAE
;
Hui-Seung LEE
;
Chi-Yeon LIM
;
Jang-Hee CHO
;
Byung Chul YU
;
Miyeun HAN
;
Sang Heon SONG
;
Gang-Jee KO
;
Jae Won YANG
;
Sungjin CHUNG
;
Yu Ah HONG
;
Young Youl HYUN
;
In O SUN
;
Hyunsuk KIM
;
Won Min HWANG
;
Sung Joon SHIN
;
Soon Hyo KWON
;
Kyung Don YOO
;
- Publication Type:Original Article
- From:Kidney Research and Clinical Practice
2025;44(4):664-678
- CountryRepublic of Korea
- Language:English
-
Abstract:
Early mortality following hemodialysis initiation hinders survival improvement in older patients. This study aimed to develop a clinical risk model for predicting 6-month mortality after dialysis initiation in older Korean hemodialysis patients. Methods: We analyzed data from incident hemodialysis patients aged >70 years from the Korean Society of Geriatric Nephrology (KSGN) database. A prediction model was developed using multivariate logistic regression analysis and externally validated with independent datasets. Results: Among 1,751 incident hemodialysis patients, the 6-month mortality rate was 15.5%. Using multivariate logistic analysis, we constructed the KSGN score as an independent risk factor for 6-month mortality, and its components and score are as follows: old age at dialysis initiation (≥85 years, score 2); hypertension and renovascular disease as a primary etiology of end-stage kidney disease (ESKD) (score 1); malignancy history (yes, score 1); low serum albumin (<3.5 g/dL, score 1); hypertension treatment (yes, score –1); prepared vascular access on maintenance dialysis (arteriovenous fistula/arteriovenous graft, score –3). In the development cohort, the area under the curve (AUC) for the KSGN score was significantly higher than the Alberta Wick’s score (0.707 vs. 0.683, p = 0.001). In the validation cohort, the KSGN score’s performance was comparable to existing models. Conclusion: The KSGN score may be a valuable tool for predicting early mortality after dialysis initiation in older patients with ESKD, aiding in decision-making and management regarding dialysis initiation.
