Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan-Feb;27(1):51-57.
doi: 10.4103/0971-4065.177210.

Hemodialysis outcomes and practice patterns in end-stage renal disease: Experience from a Tertiary Care Hospital in Kerala

G R Lakshminarayana  1 , L G Sheetal  2 , A Mathew  3 , R Rajesh  3 , G Kurian  3 , V N Unni  4
Affiliations

Hemodialysis outcomes and practice patterns in end-stage renal disease: Experience from a Tertiary Care Hospital in Kerala

G R Lakshminarayana et al. Indian J Nephrol. 2017 Jan-Feb.

Abstract

This study was planned to analyze the hemodialysis practice patterns from a tertiary care referral centre as there is very limited data from India. All patients of ESRD on maintenance hemodialysis (MHD) in dialysis unit at AIMS, Kochi, Kerala for a minimum period of 3 months were included. A total of 134 patients (M: F 2:1) with age of 20 to 84 years (Mean: 59.83; SD: 11.98) were studied. The most common causes of ESRD in study population were diabetic nephropathy (DN) (59.7%) followed by unclassified group (19.4%), chronic glomerulonephritis (CGN) (11.9%). Majority (81%) were initiated on MHD through temporary vascular access on emergency basis. Majority (79%) of the patients were on twice weekly MHD. The range of eGFR (ml/min/1.73 m2) at the time of initiation of MHD was 1.26-11.78 by CG formula and 2.18-16.4 by MDRD equation. The mean duration on hemodialysis was 37.16 months and 50.7% patients had died during the follow-up period (3-108 months). The mean survival time on hemodialysis was 40.31 months (SD = 26.69). The mean survival time was lower in diabetic nephropathy (35.93 months) than in non-diabetic renal disease (47.46 months). The most common causes of deaths were cardiovascular events (51.5%), and infections (26.5%). In conclusion, males outnumbered females, among those on hemodialysis. There was no significant difference in eGFR at initiation of MHD based on etiologies. Initiation of MHD via temporary access, presence of LVH, acute coronary syndrome, use of acetate dialysate, need for parenteral iron therapy had impact on mortality. Survival rates while on hemodialysis at end 1st, 3rd, 5th and 7th years were 87.31, 45.52, 21.64 and 7.46 percentages respectively.

Keywords: End-stage renal disease; hemodialysis; mortality risk factors; survival rate.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Survival graph of all patients
Figure 2
Figure 2
Survival graphs: Comparison between diabetic chronic kidney disease and nondiabetic chronic kidney disease. (Curve 1: Diabetic chronic kidney disease, and Curve 2: Nondiabetic chronic kidney disease)
See this image and copyright information in PMC

References

    1. Hecking M, Bieber BA, Ethier J, Kautzky-Willer A, Sunder-Plassmann G, Säemann MD, et al. Sex-specific differences in hemodialysis prevalence and practices and the male-to-female mortality rate: The dialysis outcomes and practice patterns study (DOPPS) PLoS Med. 2014;11:e1001750. - PMC - PubMed
    1. Port FK. Practice-based versus patient-level outcomes research in hemodialysis: The DOPPS (Dialysis Outcomes and Practice Patterns Study) experience. Am J Kidney Dis. 2014;64:969–77. - PubMed
    1. Lopes AA, Bragg-Gresham JL, Elder SJ, Ginsberg N, Goodkin DA, Pifer T, et al. Independent and joint associations of nutritional status indicators with mortality risk among chronic hemodialysis patients in the dialysis outcomes and practice patterns study (DOPPS) J Ren Nutr. 2010;20:224–34. - PubMed
    1. Chandrashekar A, Ramakrishnan S, Rangarajan D. Survival analysis of patients on maintenance hemodialysis. Indian J Nephrol. 2014;24:206–13. - PMC - PubMed
    1. Rao M, Juneja R, Shirly RB, Jacob CK. Haemodialysis for end-stage renal disease in Southern India – A perspective from a tertiary referral care centre. Nephrol Dial Transplant. 1998;13:2494–500. - PubMed