ABSTRACT
Objective To analyze the causes of early death in elderly patients undergoing maintenance hemodialysis ( MHD) and major risk factors.Methods A retrospective study was conducted.Fourty-three patients who had undergone MHD between January 2005 and December 2015 and died within 3 -12 months after hemodialysis in the Hemodialysis Center of China Aerospace Center Hospital were included in Group A while 106 patients who had undergone hemodialysis in the same period but survived for over 12 months were selected as control group(Group B).Results The main causes of early death of 43 elderly patients with MHD were cardiovascular ( 46.5%) and cerebrovascular diseases ( 25.6%) (CCVD), and infections(14.0%).The age,proportion of patients with diabetes and CVD,and the proportion of patients using the central venous catheter( CVC) as vascular access were higher in Group A,but the level of hemoglobin and serum albumin was lower.Indicators of cardiac structure and function showed that the left ventricular end-diastolic diameter (LVDd),left ventricular posterior wall thickness(LVPWT),and left ventricular myocardial quality index(LVMI)in Group A were well above those in Group B, but EF and E/A ratio were significantly lower(P<0.05 and P<0.01).COX regression analysis indicated that the comorbidity with CVD, a lower level of serum albumin and EF were the main risk factors for early mortality in elderly patients under MHD.Conclusion The main cause of early death in elderly MHD patients is CCVD.The comorbidity of CVD, malnutrition and decreased left ventricular systolic function might be the main risk factors for early mortality in elderly MHD patients.Early and adequate dialysis,active treatment of underlying diseases, and the correction of hypoalbuminemia can decrease complications,prolong life and improve the quality of life.