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2017 ; 130
(8
): 885-891
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Analysis of Factors Associated with Death in Maintenance Hemodialysis Patients: A
Multicenter Study in China
#MMPMID28397716
Song KK
; Zhao DL
; Wang YD
; Wang Y
; Sun XF
; Miao LN
; Ni ZH
; Lin HL
; Liu FY
; Li Y
; He YN
; Wang NS
; Wang CL
; Zhang AH
; Chen MH
; Yang XP
; Deng YY
; Shao FM
; Fu SX
; Fang JA
; Cai GY
; Chen XM
Chin Med J (Engl)
2017[Apr]; 130
(8
): 885-891
PMID28397716
show ga
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.