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. 2023 Mar 30;13(4):605.
doi: 10.3390/jpm13040605.

Prognosis Factors of Patients Undergoing Renal Replacement Therapy

José Manuel Muñoz-Terol  1   2 , José L Rocha  1   2 , Pablo Castro-de la Nuez  3 , Juan José Egea-Guerrero  4   5 , Luis Gil-Sacaluga  1 , Emilio García-Cabrera  6 , Angel Vilches-Arenas  6   7
Affiliations

Prognosis Factors of Patients Undergoing Renal Replacement Therapy

José Manuel Muñoz-Terol et al. J Pers Med. .

Abstract

Background: Survival in patients with end-stage kidney disease (ESKD) on renal replacement therapy (RRT) is less than that of the general population of the same age, and depends on patient factors, the medical care received, and the type of RRT used. The objective of this study is to analyze the factors associated with survival in patients undergoing RRT.

Methods: We conducted a retrospective observational study of adult patients with an incident of ESKD on RRT in Andalusia from 1 January 2008 to 31 December 2018. Patient characteristics, nephrological care received, and survival from the beginning of RRT were evaluated. A survival model for the patient was developed according to the variables studied.

Results: A total of 11,551 patients were included. Median survival was 6.8 years (95% CI (6.6; 7.0)). After starting RRT, survival at one year and five years was 88.7% (95% CI (88.1; 89.3)) and 59.4% (95% CI (58.4; 60.4)), respectively. Age, initial comorbidity, diabetic nephropathy, and a venous catheter were independent risk factors. However, non-urgent initiation of RRT and follow-up in consultations for more than six months had a protective effect. It was identified that renal transplantation (RT) was the most influential independent factor in patient survival, with a risk ratio of 0.13 (95% CI (0.11; 0.14)).

Conclusions: The receiving of a kidney transplant was the most beneficial modifiable factor in the survival of incident patients on RRT. We consider that the mortality of the renal replacement treatment should be adjusted, taking into account both modifiable and nonmodifiable factors to achieve a more precise and comparable interpretation.

Keywords: end-stage kidney disease; kidney transplantation; premature mortality; renal replacement therapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Global survival of renal replacement therapy.
Figure 2
Figure 2
Univariate survival analysis comparing the modality of renal replacement therapy at the start.
Figure 3
Figure 3
Cox multivariate analysis comparing patients with renal transplantation.
See this image and copyright information in PMC

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