2021, Vol. 3, Issue 1, Part I

Author(s): Dr. Sireesha Gunnam, Dr. Raghuram Uppalapati and Dr. Gullipalli Prasad

Abstract: Materials and Methods: A total of 396 patients with end stage renal disease who were started on maintenance hemodialysis twice or thrice weekly over a period of 4 years from May 2016 to May 2020 were studied. Follow up was censored at the time of death or at the end of the 4year study period, whichever occurred first. Results: Of the 396 patients studied (mean age 48.6 ± 14.55 years, male: female-2:1 and 51.5% are diabetics), 213 patients died by end of one year with mortality rate of 53.7%. Chronic interstitial nephritis (34.3%) is most common etiology. In Cox proportional hazard analyses, patient survival was associated with female sex, low serum albumin, native kidney urine output, presence of left ventricular hypertrophy (LVH) &ejection fraction <50% on two dimensional echocardiography, compliance to dialysis, and interdialytic weight gain (>3kg) independently predicted mortality. There was no significant difference between diabetics and non diabetics in relation to death (Relative Risk = 0.214; 95% CI = 0.005–10.02, P = 0.005). Conclusions: This study revealed that mortality among hemodialysis patients was high in the first 120 days after initiation of dialysis. Female gender, low serum albumin, Low EF <50% & LVH in 2D Echo, low native kidney urine output, poor compliance to dialysis and high interdialytic weight gain (>3kg) are associated with increased risk of death. Strategies to prevent cardiovascular events and improve nutrition increases survival outcomes in hemodialysis patients.

DOI: 10.22271/27069567.2021.v3.i1i.252

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