Mortality and Practice Patterns in the MEXHEMO Hemodialysis Cohort

Area of Science:

• Nephrology
• Public Health
• Epidemiology

Background:

• Chronic kidney disease (CKD) is a significant public health issue in Mexico.
• Limited epidemiological data exists on Mexican patients undergoing chronic hemodialysis (HD) due to the absence of a national registry.
• Understanding patient profiles and outcomes is crucial for addressing CKD burden.

Purpose of the Study:

• To characterize the clinical profile and outcomes of Mexican patients receiving maintenance hemodialysis.
• To establish the MEXHEMO cohort, the largest reported group of HD patients in Mexico.
• To identify factors associated with mortality in this population.

Main Methods:

• Retrospective, observational cohort study.
• Data collected from 41 clinics nationwide for patients on maintenance HD between January 1 and June 30, 2023.
• Outcomes included mortality rates and standardized mortality ratios (SMRs) compared to USRDS and Chilean registries.

Main Results:

• 11,779 patients included; mean age 52 ± 16 years, 57% male, 92% with social security.
• High-flux HD used in 86%, dialyzer reuse in 43%.
• Crude mortality rate: 130 deaths/1000 patient-yrs. SMRs were 1.31 (vs. USRDS) and 1.57 (vs. Chile).
• Independent mortality risk factors: lack of social security, hypoalbuminemia, Hb ≤ 9 g/dl, catheter use, dialyzer reuse.

Conclusions:

• MEXHEMO represents the largest cohort of HD patients in Mexico.
• Elevated mortality observed despite a relatively young patient population.
• Findings underscore the urgent need for a national HD registry and quality improvement initiatives in Mexico.