EVALUATION OF FACTORS INFLUENCING SURVIVAL AMONGST PATIENTS ON MAINTAINENCE HAEMODIALYSIS

Dr Brijesh Verma, Dr Nitin Nahar

Abstract


INTRODUCTION- Survival of patients on hemodialysis depend upon multiple risk factors. Common independent
predictors of survival are age, race, serum albumin at the start of dialysis, activity level at the start of dialysis, and
presence of certain comorbidities such as heart failure and cancer. The present study was thus conducted to assess the
factors influencing survival among patients on maintenance haemodialysis.
METHODOLOGY- The study was conducted as a prospective study in Department of Medicine, Gandhi Medical
College and associated Hamidia Hospital, Bhopal for a period of 2 year on 100 patients with ESRD. All adult patients with
ESRD who survived first 3 months on maintenance hemodialysis and consenting for the study were included in the study.
Detailed data pertaining to causes and risk factors of CKD, clinical conditions of patients at initiation and last session of
dialysis and treatments given was obtained and entered in questionnaire. Patients were followed up at 4 monthly interval
for a total duration of 2 years and survival was noted. Data was compiled using Ms Excel and analysed using SPSS
software version 20.
RESULTS- Overall mortality in present study was documented to be 34% and mean survival time was observed to be 2.4
(CI-2.248-2.605) years. Mortality was significantly higher in patients with hypertension, severe anemia,
hypalbuminemia, hypocalcemia, hyperphosphatemia, hypercholesterolemia, diabetic, high grade urea and creatinine,
hypernatremia, hyperkalemia, diabetes and infections (p<0.05).
CONCLUSION- The present study documented overall mortality of 34% and the mean survival time was 2.4 (CI-2.248-
2.605) years following initiation of dialysis.The risk factors associated with increased mortality were hypertension,
severe anemia, severely deranged liver, lipid and renal profile (p<0.05). Also diabetes, anemia, infections and
hypertension (p<0.05) were poor predictors of survival and were significantly associated with mortality.


Keywords


Survival Pattern, Esrd, Risk Factors, Albumin, Creatinine

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References


Levey AS, Coresh J. Chronic kidney disease. Lancet 2012;379:165-80.

Hsu CY, Vittinghoff E, Lin F, Shlipak MG. The incidence of end-stage renal disease is increasing faster than the prevalence of chronic renal insufficiency. Ann Intern Med 2004;141:95-101.

Kazancioglu R. Risk factors for chronic kidney disease: an update. Kidney international supplements. 3 (2013): 368-371.

Tonelli M, Wiebe N, Culleton B, et al. Chronic Kidney Disease and Mortality Risk: A Systematic Review. Journal of the American Society of Nephrology 17 (2006): 2034-2047.

Bleyer AJ, Tell GS, Evans GW, Ettinger WH, Burkart JM: Survival of patients undergoing renal replacement therapy in one center with special emphasis on racial differences. Am J Kidney Dis. 1996, 28 (1): 72-81. 10.1016/S0272-6386(96)90133-X.

Honda H, Qureshi AR, Heimburger O, Barany P, Wang K, Pecoits-Filho R, Stenvinkel P, Lindholm B: Serum albumin, C-reactive protein, interleukin 6, and fetuin a as predictors of malnutrition, cardiovascular disease, and mortality in patients with ESRD. Am J Kidney Dis47 :139– 148,2006

Christensen AJ, Ehlers SL. Psychological factors in endstage renal disease: an emerging context for behavioral medicine research. J Consult Clin Psychol. 2002;70:712-24

Griffin KW. Comparison of quality of life in haemodialysis and peritoneal dialysis patients. In: Khanna R, editor. Advances in peritoneal dialysis. Toronto: Peritoneal Dialysis Publications; 1994: p. 104-8.

Shibiru T, Gudina EK, Habte B, Deribew A, Agonafer T. Survival patterns of patients on maintenance hemodialysis for end stage renal disease in Ethiopia: summary of 91 cases. BMC nephrology. 2013 Dec;14(1):127.

Chandrashekar A, Ramakrishnan S, Rangarajan D. Survival analysis of patients on maintenance hemodialysis. Indian journal of nephrology. 2014 Jul;24(4):206.

Kovesdy CP, Regidor DL, Mehrotra R, Jing J, McAllister CJ, Greenland S, et al. Serum and dialysate potassium concentrations and survival in hemodialysis patients. Clin J Am Soc Nephrol. 2007;2:999–1007

Prabha D R, Prasad G. Predictors of mortality among patients on maintenance hemodialysis. J NTR Univ Health Sci 2016;5:255-60

Khazaei S, Yaseri M, Nematollahi S, Zobdeh Z, Sheikh V, Mansournia MA. Survival rate and predictors of mortality among hemodialysis patients in West of Iran, 1996–2015. Int J Prev Med 2018;9:113

Urrutia JD, Gayo WS, Bautista LA, Baccay EB. Survival Analysis of Patients with End Stage Renal Disease. InJournal of Physics: Conference Series 2015 (Vol. 622, No. 1, p. 012014). IOP Publishing.

Angelo BZ, Tessarollo C, Carvalho VDB, Lemos TC, Koch MC, Maraschin JF. Fatores preditores de mortalidade em pacientes diabéticos em terapia de substituição renal em Tubarão-SC. Arq Catar Med 2010;39:23-8.

Madziarska K, Weyde W, Penar J, Zukowska-Szczechowska E, Krajewska M, Golebiowski T, Klak R, Zmonarski S, Kozyra C, Klinger M. Different mortality predictor pattern in hemodialysis and peritoneal dialysis diabetic patients in 4-year prospective observation. Postepy Hig Med Dosw (Online). 2013 Nov 20;67:1076-82.

Bradbury BD, Fissell RB, Albert JM, Anthony MS, Critchlow CW, Pisoni RL, et al. Predictors of early mortality among incident US hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Clin J Am Soc Nephrol 2007;2:89-99


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