Factors Associated with Mortality in Maintenance Hemodialysis Patients: A Single-Center Data from East Anatolian Region of Turkey

Abstract

Objectives: Patients on maintenance hemodialysis have a high mortality risk compared to the general population. There have been reported many risk factors that affect the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of these patients and to identify risk factors that contributed to their mortality. Materials and Methods: This study was a retrospective observational cohort study conducted between January 2018 and January 2020. At the start of the study, all of patients were clinically evaluated, and data regarding demographic, clinic, and laboratory characteristics were collected. At the end of 2-year follow-up period, the patients were separated into two groups according to their survival status. Data were analyzed between the survival and death groups. Logistic regression analysis was used to evaluate risk factors associated with mortality. Results: A total of 74 patients (53% females and 47% males) were included in the analysis. The mean age of the study population was 53.04±14.61 years. At the end of 2-year follow-up period, 21 (28.4) patients died, and four (5.4) received a kidney transplant. The leading cause of death was cardiovascular events (52.2%), followed by infections (43%). Compared with the survival group, the death group patients had higher rate of comorbid conditions, older age, required higher erythropoiesis stimulating agent doses, lower levels of serum creatinine and albumin, and higher levels of C-reactive protein (CRP). The presence of diabetes mellitus, cerebrovascular disease, and high CRP levels are independent risk factors for mortality. Conclusion: An early and careful evaluation is essential in the follow-up of the patients in order to improve survival in this group of patients. Largescale multicenter studies are needed to better determine the causes of increased risk of mortality in maintenance hemodialysis patients. Key Words: Mortality, Risk Factors, Hemodialysis

Keywords

• Mortality
• Risk Factors
• Hemodialysis

Hemodiyaliz Hastalarında Mortalite ile İlişkili Faktörler: Türkiye’nin Doğu Anadolu Bölgesinden Tek Merkezli Bir Veri

Abstract

Amaç: Hemodiyaliz hastaları genel popülasyona göre yüksek mortalite riskine sahiptir. Bu hastaların mortalitesini etkileyen birçok risk faktörü bildirilmiştir. Bu çalışmanın amacı, bu hastaların klinik ve laboratuvar özelliklerini değerlendirmek ve mortalitelerine katkıda bulunan risk faktörlerini tanımlamaktır. Gereç ve Yöntem: Çalışma Ocak 2018 ile Ocak 2020 arasında yapılan retrospektif gözlemsel bir kohort çalışmasıdır. Çalışmanın başlangıcında tüm hastalar klinik olarak değerlendirildi ve demografik, klinik ve laboratuvar özellikleri ile ilgili veriler toplandı. İki yıllık takip süresinin sonunda hastalar sağkalım durumuna göre iki gruba ayrıldı. Hayatta kalan ve ölen gruplar arasında veriler analiz edildi. Mortalite ile ilişkili risk faktörlerini değerlendirmek için lojistik regresyon analizi kullanıldı. Bulgular: Toplam 74 hasta (%53 kadın ve %47 erkek) analize dahil edildi. Çalışma popülasyonunun ortalama yaşı 53,04±14,61 yıl idi. İki yıllık takip süresinin sonunda 21 (28,4) hasta öldü ve dört (5,4) hastaya böbrek nakli uygulandı. Önde gelen ölüm nedeni kardiyovasküler olaylar (%52,2), ardından enfeksiyonlar (%43) idi. Hayatta kalan hasta grubuyla karşılaştırıldığında, ölen hasta grubunda daha yüksek komorbid durumlar, daha ileri yaş, daha yüksek eritropoezi uyarıcı ajan dozları, daha düşük serum kreatinin ve albümin seviyeleri ve daha yüksek C-reaktif protein (CRP) seviyeleri gözlendi. Diabetes mellitus, serebrovasküler hastalık ve yüksek CRP seviyeleri mortalite için bağımsız risk faktörleri idi. Sonuç: Bu hasta grubunda sağkalımı artırmak için hastaların takibinde erken ve dikkatli bir değerlendirme şarttır. Hemodiyaliz hastalarında mortalite riskinin artmasının nedenlerini daha iyi belirlemek için büyük ölçekli çok merkezli çalışmalara ihtiyaç vardır. Anahtar Kelimeler: Mortalite, Risk Faktörleri, Hemodiyaliz

Keywords

• Mortalite
• Risk Faktörleri
• Hemodiyaliz

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