Risk factor analysis of death within the first 3 months of hemodialysis in patients with end stage nephropathy
Objective To analyze the causes of death within the first 3 months of hemodialysis in patients with end stage nephropathyand to explore the risk factors affecting survival within the first 3 months in hemodialysis patients, so as to provide some potential solutions to improve the survival of hemodia...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Department of Journal of Clinical Nephrology
2019-01-01
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| Series: | Linchuang shenzangbing zazhi |
| Subjects: | |
| Online Access: | http://www.lcszb.com/thesisDetails?columnId=57912066&Fpath=home&index=0 |
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| Summary: | Objective To analyze the causes of death within the first 3 months of hemodialysis in patients with end stage nephropathyand to explore the risk factors affecting survival within the first 3 months in hemodialysis patients, so as to provide some potential solutions to improve the survival of hemodialysis patients within the first 3 months.Methods All the patients with end stage nephropathy starting hemodialysis between 1 January 2010 to 31 December 2013 in Department of Nephrology, West China Hospital of Sichuan University were included and followed-up until March 1, 2017. All the patients who died within the first 3 months of hemodialysis were used as the trial group, and all the patients who survived in the first 3 months as the control group. Baseline conditions and laboratory results were compared between the two groups. Logistic regression analysis of the related risk factors was performed.Results A total of 1 268 patients with end stage nephropathy starting hemodialysis were included, of which 438 ones died. Their baseline diseases mainly included chromic glomerulonephritis(50.47%), diabetes(23.03%), hypertension(9.31%). The mortality peak in the patients with new hemodialysis appeared within the first 3 months of hemodialysis, with a total of 155 death cases, accounting for 35.4% of all the died patients. The baseline diseases in the patients who died in the first 3 months of hemodialysis mainly included diabetes(32.26%), chronic glomerulonephritis(23.23%) and hypertension(15.48%). Logistic regression analysis suggested that increased Charlson comorbidity index(CCI), diabetes as a baseline disease, increased neutrophil ratio, elevated red blood cell distribution width, increased proportion of continuous renal replacement therapy(CRRT) received during disease progressionwere risk factors of death within the first 3 months, whereas increased serum albumin and high-density lipoprotein cholesterol were protective factors. In the study population, there were 292 patients with a baseline disease of diabetes, 50 ones with death within the first 3 months(17.1%), and 242 ones with survival for more than 3 months(82.9%). Logistic analysis suggested, CRRT therapy received during disease progression, increased CCI and increased neutrophil ratio were risk factors of death within the first 3 months in the patients with diabetes as a baseline disease. Conclusions The risk for death within the first 3 months of hemodialysis is high in patients with end stage nephropathy. Active treatment of patients’ complications and low protein status may help improve the early survival rate of patients. Diabetes is one of the common primary causes and death risk factors in patients with end stage nephropathy, which deserves attention. |
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| ISSN: | 1671-2390 |