Background: Patients on hemodialysis have a high-mortality risk. This study analyzed factors associated with death in patients on maintenance hemodialysis (MHD). While some studies used baseline data of MHD patients, this study used the most recent data obtained from patients just prior to either a primary endpoint or the end of the study period to find the characteristics of patients preceding death.
Methods: Participants were selected from 16 blood purification centers in China from January 2012 to December 2014. Patients' data were collected retrospectively. Based on survival status, the participants were divided into two groups: survival group and the death group. Logistic regression analysis was performed to determine factors associated with all-cause mortality.
Results: In total, 4104 patients (57.58% male, median age 59 years) were included. Compared with the survival group, the death group had more men and more patients with diabetic nephropathy (DN) and hypertensive nephropathy. The patients preceding death also had lower levels of diastolic blood pressure, hemoglobin, serum albumin, serum calcium, serum phosphate, Kt/V, and higher age. Multivariate analysis revealed that male sex (odd ratio [OR]: 1.437, 95% confidence interval [CI]: 1.094-1.886), age (OR: 1.046, 95% CI: 1.036-1.057), and presence of DN (OR: 1.837, 95% CI: 1.322-2.552) were the risk factors associated with mortality. High serum calcium (OR: 0.585, 95% CI: 0.346-0.989), hemoglobin (OR: 0.974, 95% CI: 0.967-0.981), albumin (OR: 0.939, 95% CI: 0.915-0.963) levels, and dialysis with noncuffed catheter (OR: 0.165, 95% CI: 0.070-0.386) were protective factors based on a multivariate analysis.
Conclusions: Hemodialysis patients preceding death had lower hemoglobin, albumin, and serum calcium levels. Multivariate analysis showed that male sex, age, DN, low hemoglobin, low albumin, and low serum calcium were associated with death in hemodialysis patients.
[1]Chinese Peoples Liberat Army Gen Hosp, Chinese PLA Inst Nephrol, Natl Clin Res Ctr Kidney Dis, Dept Nephrol,State Key Lab Kidney Dis, Beijing 100853, Peoples R China.
[2]Jilin Univ, Hosp 2, Dept Nephrol, Changchun 130041, Jilin, Peoples R China.
[3]Shanghai Jiao Tong Univ, Renji Hosp, Shanghai Peritoneal Dialysis Res Ctr, Sch Med,Dept Nephrol, Shanghai 200127, Peoples R China.
[4]Dalian Med Univ, Affiliated Hosp 1, Dept Nephrol, Dalian 116011, Liaoning, Peoples R China.
[5]Cent S Univ, Xiangya Hosp 2, Dept Nephrol, Changsha 410011, Hunan, Peoples R China.
[6]Hebei Med Univ, Hosp 3, Kidney Dis Res Ctr Hebei Prov, Dept Nephrol, Shijiazhuang 050081, Hebei, Peoples R China.
[7]Third Mil Med Univ, Daping Hosp, Inst Surg Res, Dept Nephrol, Chongqing 400042, Peoples R China.
[8]Shanghai Jiao Tong Univ, Affiliated Peoples Hosp 6, Dept Nephrol, Shanghai 200233, Peoples R China.
[9]Baotou Med Coll, Affiliated Hosp 1, Dept Nephrol, Baotou 014040, Inner Mongolia, Peoples R China.
[10]Peking Univ, Hosp 3, Dept Nephrol, Beijing 100191, Peoples R China.
[11]Ningxia Med Univ, Gen Hosp, Dept Nephrol, Yinchuan 750004, Ningxia, Peoples R China.
[12]Shihezi Univ, Affiliated Hosp 1, Sch Med, Dept Nephrol, Shihezi 832008, Xinjiang, Peoples R China.
[13]Shanghai Univ Tradit Chinese Med, Longhua Hosp, Dept Nephrol, Shanghai 200032, Peoples R China.
[14]Henan Prov Peoples Hosp, Dept Nephrol, Zhengzhou 450003, Henan, Peoples R China.
[15]Hebei Med Univ, Hosp 2, Dept Nephrol, Shijiazhuang 050000, Hebei, Peoples R China.
[16]Shanxi Med Univ, Hosp 1, Dept Nephrol, Taiyuan 030001, Shanxi, Peoples R China.
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