Survival of hemodialysis patients: A new reality?
Introduction: Survival rates of haemodialysis patients have increased worldwide over the last decade. The purposes of this study were to analyze the 10-year survival rate and to identify mortality risk factors in a Portuguese cohort. Subjects and Methods: Data was collected from 273 incident patients on facility haemodialysis treatments between 2005 and 2015. Sociodemographic data, medical history, clinical and analytic parameters were collected. A statistical analysis using Kaplan-Meier survival analysis and Cox regression were performed. Results: Median age was 71 ± 15.5 [22; 91] years, 56.8% were male. Fistula was the first access in 68.5%. Median survival rate was 89 ± 8.8 months. There were 93 deaths (34%). Of the 23 deaths occurring in the first year, 65% (n=15) were during the first 90 days. Mortality risk factors were residence in a nursing home (OR 2.8; p<0.05), coronary heart disease (OR 2.3; p<0.05), central venous catheter use (OR 2.1; p<0.05), history of hospitalizations in year prior to dialysis admission (OR 1.9; p<0.05) and advanced age (OR 1.5; p<0.05). Conclusions: Patients starting haemodialysis in the last decade are mainly elderly and have a prolonged lifespan, reflecting good levels of care. Functional status and dependence, extremes of age, central venous catheter use and high cardiovascular burden are related with greater mortality and should prompt consideration for a more conservative approach
| Main Authors: | , , , , , |
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| Format: | Digital revista |
| Language: | English |
| Published: |
Sociedade Portuguesa de Nefrologia
2017
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| Online Access: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000100004 |
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| Summary: | Introduction: Survival rates of haemodialysis patients have increased worldwide over the last decade. The purposes of this study were to analyze the 10-year survival rate and to identify mortality risk factors in a Portuguese cohort. Subjects and Methods: Data was collected from 273 incident patients on facility haemodialysis treatments between 2005 and 2015. Sociodemographic data, medical history, clinical and analytic parameters were collected. A statistical analysis using Kaplan-Meier survival analysis and Cox regression were performed. Results: Median age was 71 ± 15.5 [22; 91] years, 56.8% were male. Fistula was the first access in 68.5%. Median survival rate was 89 ± 8.8 months. There were 93 deaths (34%). Of the 23 deaths occurring in the first year, 65% (n=15) were during the first 90 days. Mortality risk factors were residence in a nursing home (OR 2.8; p<0.05), coronary heart disease (OR 2.3; p<0.05), central venous catheter use (OR 2.1; p<0.05), history of hospitalizations in year prior to dialysis admission (OR 1.9; p<0.05) and advanced age (OR 1.5; p<0.05). Conclusions: Patients starting haemodialysis in the last decade are mainly elderly and have a prolonged lifespan, reflecting good levels of care. Functional status and dependence, extremes of age, central venous catheter use and high cardiovascular burden are related with greater mortality and should prompt consideration for a more conservative approach |
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