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

Abstract

Background optimal management of end-stage renal disease (ESRD) in hemodialysis (HD) patients should be more studied because it is a serious risk factor for mortality, being considered an unquestionable global priority. Methods we performed a retrospective cohort study from the Nephrology Service in Brazil evaluating the survival of patients with ESRD in HD during 20 years. Kaplan-Meier method with the Log-Rank and Cox’s proportional hazards model explored the association between survival time and demographic factors, quality of treatment and laboratory values. Results Data from 422 patients were included. The mean survival time was 6.79 ± 0.37. The overall survival rates at first year was 82,3%. The survival time correlated significantly with clinical prognostic factors. Prognostic analyses with the Cox proportional hazards regression model and Kaplan-Meier survival curves further identified that leukocyte count (HR = 2.665, 95% CI: 1.39–5.12), serum iron (HR = 8.396, 95% CI: 2.02–34.96), serum calcium (HR = 4.102, 95% CI: 1.35–12.46) and serum protein (HR = 4.630, 95% CI: 2.07–10.34) as an independent risk factor for the prognosis of survival time, while patients with chronic obstructive pyelonephritis (HR = 0.085, 95% CI: 0.01–0.74), high ferritin values (HR = 0.392, 95% CI: 0.19–0.80), serum phosphorus (HR = 0.290, 95% CI: 0.19–0.61) and serum albumin (HR = 0.230, 95% CI: 0.10–0.54) were less risk to die. Conclusion survival remains low in the early years of ESRD treatment. The present study identified that elevated values of ferritin, serum calcium, phosphorus, albumin, leukocyte, serum protein and serum iron values as a useful prognostic factor for the survival time.

Resiliensi Pada Pasien Hemodialisis: Studi Literatur

“…Pasien dengan dialisis dilaporkan memiliki risiko mortalitas 10-20 kali lebih tinggi dibandingkan populasi umum. Kondisi tersebut membuat tingkat kelangsungan hidup pasien / survival rate menjadi isu yang penting pada hemodialisis (Ferreira et al, 2020). Peningkatan kelangsungan hidup pasien merupakan tujuan dan indikator keberhasilan dari terapi hemodialisis.…”

Study protocol: Effectiveness of patient centered pharmacist care in improving medication adherence, clinical parameters and quality of life among hemodialysis patients

“…An improvement in the survival rates of patients with ESRD can be seen, due to advances in dialysis treatment [2]. However, the mortality rates for patients with ESRD on chronic dialysis remain high [3] due to the presence of inflammation, undernutrition, and heart-related problems [4,5].…”

A Retrospective Study from a Single Center in China to Develop a Nomogram to Predict One-Year Mortality in Patients with End-Stage Renal Disease Who Are Receiving Hemodialysis

“…The main causes of death for patients on HD in China are cardiovascular events (40.0%), cerebrovascular events (35.9%), and infections (9.9%) [ 7 ]. Some demographic characteristics and biochemical indicators of liver and kidney function related to the risk of death in ESRD patients receiving HD were extensively proposed, such as age [ 8 ], alkaline phosphatase (AKP) [ 9 ], albumin (ALB) [ 9 ], and uric acid (UA) concentrations [ 10 ]. However, the establishment of an effective prediction model by combing multiple prognostic factors could play an important role in clinical risk assessment and individual patient’s treatment [ 11 ].…”