Evaluation of Long-term Survival and Predictors of Mortality in Hemodialysis Patients by Using Time Dependent Variables, A Single Centre Cohort Analysis

Authors

  • Samaneh Hashemi Nephrology Section, Hasheminejad Kidney Center, Iran University of Medical Science Tehran, Iran Author
  • Mohsen Vahedi Department of Biostatistics and Epidemiology, Faculty of Rehabilitation Sciences, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Author
  • Shahrzad Ossareh Nephrology Section, Hasheminejad Kidney Center, Iran University of Medical Science Tehran, Iran Author

Abstract

Introduction. Despite significant improvement in End Stage Kidney Disease (ESKD) patient’s management, and better availability of dialysis for caregivers, mortality among these patients is unacceptably high. Methods. We collected the data of 751 incident hemodialysis patients from March 2004 to November 2018. Survival curves was created by using the Kaplan-Meier method. Comorbidities, as well as time-dependent values of laboratory findings, were examined as independent factors by three models of Cox regression analysis. Results. The median follow-up period was 31.7 months (1.08 to 169.28). Patient survival rates were 88%, 77%, 56%, 32%, 26% ,16% and 12%, at 1, 2, 4,6, 8, 10, 12 and 14 years of follow-up, respectively. The most common cause of mortality was cardiovascular disease. We observed lower survival rates in patients ≥ 65 years (HR = 2.684, 95% CI: 1.133 to 3.377; P < .001), diabetes mellitus (HR = 1.729, 95% CI: 1.484 to 2.014; P < .001) and walking disability (HR = 2.505; 95% CI: 2.104 to 2.983; P < .001). Low hemoglobin level (HR = 1.496; 95% CI: 1.257 to 1.779; P < .001), hyperphosphatemia (HR = 1.305, 95% CI: 1.104 to 1.542; P = 0.002) and high low-density lipoprotein cholesterol level (HR = 1.933; 95% CI: 1.431 to 2.611; P < .001) were predictors of mortality. A single pool Kt/V > 1.2 (HR = 0.743, 95% CI: 0.635 to 0.870; P < .001) and high serum creatinine level (HR = 0.842, 95% CI: 0.811 to 0.874; P < .001) showed protective effects. Conclusion. Our study showed a high survival rate in a single center cohort of hemodialysis patients in Iran. Traditional risk factors of mortality in general population, as well as indices of dialysis efficacy and general health status were the main predictors of mortality. Nationwide registries are necessary to investigate the dialysis survival rates and their predictors in our country.

 

DOI: 10.52547/ijkd.6435

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Author Biographies

  • Samaneh Hashemi, Nephrology Section, Hasheminejad Kidney Center, Iran University of Medical Science Tehran, Iran
    Nephrology section, Department of Medicine, Iran University of Medical Sciences, Hasheminejad Kidney Center
  • Mohsen Vahedi, Department of Biostatistics and Epidemiology, Faculty of Rehabilitation Sciences, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

    Department of  Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.Assistant Professor, 

  • Shahrzad Ossareh, Nephrology Section, Hasheminejad Kidney Center, Iran University of Medical Science Tehran, Iran

    Shahrzad Ossareh- M.D. 
    Professor of Medicine 

    Head, Section of Nephrology and Hemodialysis Ward, Hasheminejad Kidney Center, 
    Iran University of Medical Sciences

    Director of Nephrology and Fellowship Program, Hasheminejad Kidney Center, Iran University of Medical Sciences

    Address: Vanak sq., Tehran 1969714713-Iran 

    Tel: 0098-21-8864 4420, Fax: 0098-21-8864 4441


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Published

2021-09-26

Issue

Section

ORIGINAL | Dialysis

How to Cite

Evaluation of Long-term Survival and Predictors of Mortality in Hemodialysis Patients by Using Time Dependent Variables, A Single Centre Cohort Analysis. (2021). Iranian Journal of Kidney Diseases, 15(5), 373-384. https://www.ijkd.org/index.php/ijkd/article/view/6435

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