The first year influencing factors for survival status in elderly maintenance hemodialysis patients
Received:February 22, 2016  Revised:June 30, 2016
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DOI:10.11915/j.issn.1671-5403.2016.08.0143
Key words:hemodialysis  aged  survival  influencing factor
Author NameAffiliationE-mail
LIU Cui-Ping*, QIN Yan, WANG Ting-Ting, GAO Mao-Long Department of Nephrology, Beijing Geriatric Hospital, Beijing 100095, China 15011382998@163.com 
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Abstract:
      Objective To analyze the survival status of elderly patients receiving maintenance hemodialysis (MHD) during the first year of dialysis. Methods Fifty-six elderly patients with end stage renal disease who were newly admitted in Blood Purification Center of Beijing Geriatric Hospital from 1 June, 2010 to 31 December, 2013 for hemodialysis were recruited in this study. All the patients were followed up for 1 year, and their clinical data were collected. According to the outcomes, the patients were divided into the death group and survival group. The data were compared between the 2 groups, and multivariate logistic regression analysis was used to analyze the risk factors for death. Results At the end of 1 year’s follow-up, 22 cases died. They were assigned into the death group, and the other 30 cases who received continued dialysis in our Center were into the survival group. The mortality within the first year of dialysis was 39.3%, and was 17.9% in the first 3 months. There were significant differences in the percentages of the patients complicated with diabetes and congestive heart failure, estimated glomerular filtration rate (eGFR, calculated by the C-G formula), serum levels of albumin and C-reactive protein, and subjective global assessment (SGA) scores of nutritional status between the 2 groups (P<0.05). Multivariate logistic regression analysis showed that diabetic nephropathy as primary disease, and eGFR, albumin, C-reactive protein, SGA score and complication of congestive heart failure at the beginning of dialysis were risk factors for death in the MHD patients within the first year of dialysis. Among them, complication with congestive heart failure at the beginning of dialysis was the most dangerous factor. The main causes of death were cardiovascular disease (54.5%) and cerebrovascular disease (22.7%). Conclusion Elderly patients with end-stage renal disease are the majority for MHD. They are at high risk of death within the first year of dialysis, especially the first 3 months. Cardiovascular disease is main cause of death. Clinicians should pay attention to and vigorously control the risk factors of death in order to promote the early survival rate for the elderly MHD patients.
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