Predictors of mortality in hemodialysis patients

Abstract

Introduction Mortality in patients with chronic renal failure is high compared to the general population. The objective of our study is to evaluate the predictive factors related to mortality in hemodialysis. Methods This is a retrospective study involving 126 hemodialysis patients in the Nephrology Department of Ibn Rochd Hospital, Casablanca. Data were collected between January 2012 and January 2016. For each of our patients, we analyzed demographic, clinical, biological and anthropometric data. The Kaplan-Meier method and the log-rank test were used to evaluate and compare survival curves. To evaluate the effect of predictors of mortality, we used the proportional Cox hazard model. Results The analysis of the results showed that the surviving patients were younger than the deceased patients (43.07±13.52 years versus 53.09±13.56 years, p=0.001). Also, the latter has a significantly lower albumin and prealbumin levels (p=0.01 and p=0.04 respectively). Overall survival was 80.2%. Cox regression analysis at age (HR=1.26, p<0.0002), inflammation (HR=1.15, p<0.03), AIP> 0.24 (HR=2.1, p<0.002) and cardiovascular disease (RR=2.91, p<0.001) were associated with global and cardiovascular mortality. Conclusion Our study showed that the mortality rate is high in our cohort. In addition, cardiovascular diseases, under nutrition and inflammation are predictive factors for mortality. Treatment and early management of these factors are essential for reducing morbidity and mortality.

Association between low serum prealbumin levels and carpal tunnel syndrome in maintenance hemodialysis patients

“…Protein-energy malnutrition in dialysis patients is frequently noted, multifactorial, and typically begins well before the start of hemodialysis. Protein-energy malnutrition results from an imbalance between the contributions and the needs of the organism, resulting in tissue losses with deleterious functional consequences associated with a high morbidity and with an unfavorable prognosis, and this notion was confirmed in our previous studies [ 33 ]. Prealbumin is an acute phase protein, and serum prealbumin levels are regarded as a reliable indicator for evaluating nutritional states and the effect of nutritional intervention in MDH patients.…”

Survival and analysis of predictors of mortality in patients undergoing replacement renal therapy: a 20-year cohort

“…The 10-year cohort of Kato, Castro and Natarajan (2013) [ 45 ] indicated a high risk of mortality also in HD patients with serum albumin levels ≤3.8 g/dl; Teixeira et al (2015) [ 27 ] also found that albumin is related to low survival; Msaad et al (2019) [ 44 ] reported that 77.27% of deceased patients had low albumin and Ebhahimi et al (2019) [ 4 ] demonstrated that for each unit (in g/dl) of increase in serum albumin, the survival time for HD patients increased by approximately 23%.…”

Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis

“…ESRD patients with frailty are vulnerable to adverse outcomes including an increased risk of disability, hospitalization, and mortality [ 19 ]. Two previous studies have also demonstrated the relationship between frailty in hemodialysis and adverse outcome, such as death [ 20 , 21 ]. Moreover, despite improved care and innovative technological advancements in hemodialysis, the mortality of patients with ESRD is 10−30 times greater than that of the general population [ 22 ].…”