[Study on the mortality-related factors in patients undergoing maintenance hemodialysis]

To identify the mortality-related factors in patients undergoing maintenance hemodialysis.

One hundred and seven long-term hemodialysis patients having suffered from chronic glomerulonephritis and received hemodialysis treatment in the hemodialysis center of the Friendship Hospital during February 1990 to February 2002 were selected to take part in a retrospective study. Survival analysis was done using Life Tables study. Cox regression analysis was used to find factors related to risk. Patients were divided into two groups according to the clinical value of the factors which showed statistical significance in Cox regression analysis. Survive rates were compared between two groups on Gehan test.

Among the 107 patients, 22 died (15.3%) and 85 survived (84.7%) during the follow-up period. Cumulative survival rates of 5 years and 10 years were 79.91% and 64.36% respectively. Prognostic factors would include age (P < 0.001), blood urea nitrogen (BUN, P = 0.004), serum creatinine (SCr, P = 0.001), value of plasma calcium multiplied by plasma phosphate (P = 0.019), and KT/V (P = 0.001), which were all tested during the third dialysis month. The Hazard Ratios (HR) were 1.107 (95% Confidence Interval, 95% CI: 1.049 - 1.168), 0.951 (95% CI: 0.918 - 0.984), 0.727 (95% CI: 0.599 - 0.883), 1.025 (95% CI: 1.004 - 1.046), and 0.013 (95% CI: 0.001 - 0.161), respectively. The survival rates between two groups were significant different (age >or= 60 years group vs < 60 years group P = 0.0006, BUN >or= 28.6 mmol/L vs < 28.6 mmol/L group P = 0.0415, SCr >or= 884 micro mol/L vs < 884 micro mol/L group P = 0.0146, value of plasma calcium multiplied by plasma phosphate >or= 40 vs < 40 group P = 0.0464, KT/V >or= 1.30 vs < 1.30 group P = 0.0215).

The mortality related prognostic factors of maintained hemodialysis patients seemed to include age, BUN, SCr, value of plasma calcium multiplied by plasma phosphate, and KT/V, which were all tested during the third dialysis month. Among them, age and the value of plasma calcium multiplied by plasma phosphate were risk factors of death, while the others were protective factors.