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. 2014 Jul;24(4):206-13.
doi: 10.4103/0971-4065.132985.

Survival analysis of patients on maintenance hemodialysis

A Chandrashekar  1 , S Ramakrishnan  2 , D Rangarajan  2
Affiliations

Survival analysis of patients on maintenance hemodialysis

A Chandrashekar et al. Indian J Nephrol. 2014 Jul.

Abstract

Despite the continuous improvement of dialysis technology and pharmacological treatment, mortality rates for dialysis patients are still high. A 2-year prospective study was conducted at a tertiary care hospital to determine the factors influencing survival among patients on maintenance hemodialysis. 96 patients with end-stage renal disease surviving more than 3 months on hemodialysis (8-12 h/week) were studied. Follow-up was censored at the time of death or at the end of 2-year study period, whichever occurred first. Of the 96 patients studied (mean age 49.74 ± 14.55 years, 75% male and 44.7% diabetics), 19 died with an estimated mortality rate of 19.8%. On an age-adjusted multivariate analysis, female gender and hypokalemia independently predicted mortality. In Cox analyses, patient survival was associated with delivered dialysis dose (single pool Kt/V, hazard ratio [HR] =0.01, P = 0.016), frequency of hemodialysis (HR = 3.81, P = 0.05) and serum albumin (HR = 0.24, P = 0.005). There was no significant difference between diabetes and non-diabetes in relation to death (Relative Risk = 1.109; 95% CI = 0.49-2.48, P = 0.803). This study revealed that mortality among hemodialysis patients remained high, mostly due to sepsis and ischemic heart disease. Patient survival was better with higher dialysis dose, increased frequency of dialysis and adequate serum albumin level. Efforts at minimizing infectious complications, preventing cardiovascular events and improving nutrition should increase survival among hemodialysis patients.

Keywords: Hemodialysis; mortality; survival.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Native kidney disease
Figure 2
Figure 2
Causes of death in the cohort (n= 19)
Figure 3
Figure 3
Cumulative patient survival and dialysis dose (Kt/V)
Figure 4
Figure 4
Cumulative patient survival and frequency of hemodialysis
Figure 5
Figure 5
Cumulative patient survival and serum albumin level
Figure 6
Figure 6
Cumulative patient survival and diabetes status
See this image and copyright information in PMC

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