Abstract:

Objective To analyze deaths of patients undergoing maintenance hemodialysis (MHD) and provide evidence for improving longtime survival in MHD patients. Methods Clinical data of MHD patients admitted in our hospital for the first time from January 1, 2009 to December 31, 2014 were collected and causes of death and related risk factors were analyzed. Results One hundred and seveny-six patients were enrolled. The mean age of starting hemodialysis was 58.2±16.1 years old and the mean duration of follow-up was 37.6±22.0 months. There were 33 patients (18.8%) died and the total mortality was 59.7/1 000 patients/year. The main course of death was cardiovascular and cerebrovascular diseases, which resulted in 15 deaths (45.6%). Compared with the survival group, patients in the death group had an older mean age of starting hemodialysis (P=0.000), higher proportion of patients who smoked and had a history of cardiovascular events (P=0.045, P=0.002), higher starting hemodialysis frequency (P=0.004), lower hemoglobin level and haematocrit before hemodialysis (P=0.011，P=0.012), higher level of serum high sensitivity C reactive protein (P=0.036), and lower creatinine clearance rate (P=0.049). Cox regression analysis showed that the age of starting hemodialysis (HR 1.033, 95%CI 1.007-1.061) and hemoglobin level before hemodialysis (HR 0.980, 95%CI 0.962-0.998) were independent risk factors of death in MHD patients. Conclusion The main cause of death in MHD patients are cardiovascular and cerebrovascular diseases. Older age of starting hemodialysis and lower hemoglobin level before hemodialysis cause higher death risk in MHD patients.

Key words: maintenance hemodialysis, death, risk factor, cardiovascular and cerebrovascular disease