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Multicenter Study
. 2017 Apr 20;130(8):885-891.
doi: 10.4103/0366-6999.204103.

Analysis of Factors Associated with Death in Maintenance Hemodialysis Patients: A Multicenter Study in China

Kang-Kang Song  1 , De-Long Zhao  1 , Yuan-Da Wang  1 , Yong Wang  1 , Xue-Feng Sun  1 , Li-Ning Miao  2 , Zhao-Hui Ni  3 , Hong-Li Lin  4 , Fu-You Liu  5 , Ying Li  6 , Ya-Ni He  7 , Nian-Song Wang  8 , Cai-Li Wang  9 , Ai-Hua Zhang  10 , Meng-Hua Chen  11 , Xiao-Ping Yang  12 , Yue-Yi Deng  13 , Feng-Min Shao  14 , Shu-Xia Fu  15 , Jing-Ai Fang  16 , Guang-Yan Cai  1 , Xiang-Mei Chen  1
Affiliations
Multicenter Study

Analysis of Factors Associated with Death in Maintenance Hemodialysis Patients: A Multicenter Study in China

Kang-Kang Song et al. Chin Med J (Engl). .

Abstract

Background: Patients on hemodialysis have a high-mortality risk. This study analyzed factors associated with death in patients on maintenance hemodialysis (MHD). While some studies used baseline data of MHD patients, this study used the most recent data obtained from patients just prior to either a primary endpoint or the end of the study period to find the characteristics of patients preceding death.

Methods: Participants were selected from 16 blood purification centers in China from January 2012 to December 2014. Patients' data were collected retrospectively. Based on survival status, the participants were divided into two groups: survival group and the death group. Logistic regression analysis was performed to determine factors associated with all-cause mortality.

Results: In total, 4104 patients (57.58% male, median age 59 years) were included. Compared with the survival group, the death group had more men and more patients with diabetic nephropathy (DN) and hypertensive nephropathy. The patients preceding death also had lower levels of diastolic blood pressure, hemoglobin, serum albumin, serum calcium, serum phosphate, Kt/V, and higher age. Multivariate analysis revealed that male sex (odd ratio [OR]: 1.437, 95% confidence interval [CI]: 1.094-1.886), age (OR: 1.046, 95% CI: 1.036-1.057), and presence of DN (OR: 1.837, 95% CI: 1.322-2.552) were the risk factors associated with mortality. High serum calcium (OR: 0.585, 95% CI: 0.346-0.989), hemoglobin (OR: 0.974, 95% CI: 0.967-0.981), albumin (OR: 0.939, 95% CI: 0.915-0.963) levels, and dialysis with noncuffed catheter (OR: 0.165, 95% CI: 0.070-0.386) were protective factors based on a multivariate analysis.

Conclusions: Hemodialysis patients preceding death had lower hemoglobin, albumin, and serum calcium levels. Multivariate analysis showed that male sex, age, DN, low hemoglobin, low albumin, and low serum calcium were associated with death in hemodialysis patients.

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Conflict of interest statement

There are no conflicts of interest.

Figures

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Figure 1
Flow chart of the study.
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