Modifiable Risk Factors for Early Mortality on Hemodialysis
Data of incident hemodialysis patients from 2001 to 2007 were abstracted from The Renal Disease Registry (TRDR) from central Ontario, Canada and followed until December 2008 to determine 90-day mortality rates for incident hemodialysis patients. Modifiable risk factors of early mortality were determ...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2012/435736 |
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| author | Rory McQuillan Lilyanna Trpeski Stanley Fenton Charmaine E. Lok |
| author_facet | Rory McQuillan Lilyanna Trpeski Stanley Fenton Charmaine E. Lok |
| author_sort | Rory McQuillan |
| collection | DOAJ |
| description | Data of incident hemodialysis patients from 2001 to 2007 were abstracted from The Renal Disease Registry (TRDR) from central Ontario, Canada and followed until December 2008 to determine 90-day mortality rates for incident hemodialysis patients. Modifiable risk factors of early mortality were determined by a Cox model. In total, 876 of 4807 incident patients died during their first year on dialysis; 304 (34.7%) deaths occurred within the first 90 days of dialysis initiation. The majority of deaths were attributed to a cardiovascular event or infection and more likely occurred in older patients and those with cardiovascular co-morbidities. Of potentially modifiable risk factors, low body mass index (<18.5), a surrogate for malnutrition, was a strong predictor of early mortality [adjusted hazard ratio (HR) 4.22 (CI: 3.12–5.17)]. Also, central venous catheter use was associated with a 2.40 fold increase risk of death (CI: 1.4–3.90). Patients who attended a multidisciplinary pre-dialysis clinic were less likely to die (HR: 0.60, CI: 0.47–0.78). The first 90 days after initiation of dialysis is a period of especially high risk of death. We have identified potentially modifiable risk factors in vascular access type, pre-dialysis care and nutritional status. |
| format | Article |
| id | doaj-art-d375f92af2e14d88a7262a46a7a5fda9 |
| institution | Kabale University |
| issn | 2090-214X 2090-2158 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-d375f92af2e14d88a7262a46a7a5fda92025-02-03T06:06:23ZengWileyInternational Journal of Nephrology2090-214X2090-21582012-01-01201210.1155/2012/435736435736Modifiable Risk Factors for Early Mortality on HemodialysisRory McQuillan0Lilyanna Trpeski1Stanley Fenton2Charmaine E. Lok3Division of Nephrology, Toronto General Hospital and The University of Toronto, 8NU-844, Toronto, ON, M5G 2C4, CanadaThe Renal Disease Registry, 585 University Avenue, Toronto, ON, M5G 2C4, CanadaDivision of Nephrology, Toronto General Hospital and The University of Toronto, 8NU-844, Toronto, ON, M5G 2C4, CanadaDivision of Nephrology, Toronto General Hospital and The University of Toronto, 8NU-844, Toronto, ON, M5G 2C4, CanadaData of incident hemodialysis patients from 2001 to 2007 were abstracted from The Renal Disease Registry (TRDR) from central Ontario, Canada and followed until December 2008 to determine 90-day mortality rates for incident hemodialysis patients. Modifiable risk factors of early mortality were determined by a Cox model. In total, 876 of 4807 incident patients died during their first year on dialysis; 304 (34.7%) deaths occurred within the first 90 days of dialysis initiation. The majority of deaths were attributed to a cardiovascular event or infection and more likely occurred in older patients and those with cardiovascular co-morbidities. Of potentially modifiable risk factors, low body mass index (<18.5), a surrogate for malnutrition, was a strong predictor of early mortality [adjusted hazard ratio (HR) 4.22 (CI: 3.12–5.17)]. Also, central venous catheter use was associated with a 2.40 fold increase risk of death (CI: 1.4–3.90). Patients who attended a multidisciplinary pre-dialysis clinic were less likely to die (HR: 0.60, CI: 0.47–0.78). The first 90 days after initiation of dialysis is a period of especially high risk of death. We have identified potentially modifiable risk factors in vascular access type, pre-dialysis care and nutritional status.http://dx.doi.org/10.1155/2012/435736 |
| spellingShingle | Rory McQuillan Lilyanna Trpeski Stanley Fenton Charmaine E. Lok Modifiable Risk Factors for Early Mortality on Hemodialysis International Journal of Nephrology |
| title | Modifiable Risk Factors for Early Mortality on Hemodialysis |
| title_full | Modifiable Risk Factors for Early Mortality on Hemodialysis |
| title_fullStr | Modifiable Risk Factors for Early Mortality on Hemodialysis |
| title_full_unstemmed | Modifiable Risk Factors for Early Mortality on Hemodialysis |
| title_short | Modifiable Risk Factors for Early Mortality on Hemodialysis |
| title_sort | modifiable risk factors for early mortality on hemodialysis |
| url | http://dx.doi.org/10.1155/2012/435736 |
| work_keys_str_mv | AT rorymcquillan modifiableriskfactorsforearlymortalityonhemodialysis AT lilyannatrpeski modifiableriskfactorsforearlymortalityonhemodialysis AT stanleyfenton modifiableriskfactorsforearlymortalityonhemodialysis AT charmaineelok modifiableriskfactorsforearlymortalityonhemodialysis |