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The predictors of early mortality in patients starting chronic hemodialysis

S Gmar-Bouraoui1, H Skhiri, A Achour

  • 1Service de Néphrologie et Hémodialyse, Centre Hospitalo-universitaire Fattouma, Bourguiba, Monastir, Tunisia.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|July 28, 2007
PubMed

Insights

Early mortality in chronic hemodialysis patients is predicted by diabetes mellitus, reduced dialysis frequency, and low serum albumin. Low serum albumin (<30 g/l) is the strongest predictor of early death in these patients.

Area of Science:

  • Nephrology
  • Internal Medicine
  • Clinical Research

Background:

  • Chronic hemodialysis is a life-sustaining treatment for end-stage renal disease.
  • Early mortality remains a significant concern for patients initiating hemodialysis.
  • Identifying predictors of early mortality is crucial for improving patient outcomes.

Purpose of the Study:

  • To identify predictors of early mortality within 90 days of starting chronic hemodialysis.
  • To assess the impact of diabetes mellitus, dialysis frequency, and serum albumin on survival.

Main Methods:

  • Retrospective review of 192 patients initiating chronic hemodialysis between January 1996 and September 1999.
  • Multivariate stepwise logistic regression analysis was employed to determine significant predictors.
  • Survival rates were compared based on serum albumin levels.

Main Results:

  • Overall 90-day mortality was 16.7% (32 patients), with cardiovascular causes accounting for 50%.
  • Diabetes mellitus, reduced dialysis frequency, and low serum albumin (<30 g/l) were significant predictors of early mortality.
  • Patients with serum albumin <30 g/l had significantly lower survival rates (67.8%) compared to those with albumin ≥30 g/l (90.2%), with an odds ratio of 4.68.

Conclusions:

  • Diabetes mellitus, decreased dialysis frequency, and low serum albumin are key predictors of early mortality in hemodialysis patients.
  • Serum albumin level below 30 g/l is the most potent predictor of early mortality.
  • These findings highlight the need for targeted interventions to mitigate risks in vulnerable hemodialysis populations.

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