Analysis of the causes of death in maintenance hemodialysis patients: a 20-year single-center study / 中华老年医学杂志

ABSTRACT

Objective To analyze the causes of death of maintenance hemodialysis (MHD) patients,and to compare the long term survival rate between elderly patients and non-elderly patients and between diabetic nephropathy (DN) patients and non-DN patients at our hemodialysis center during last 20 years.Methods A total of 317 MHD patients were collected,and divided into elderly (≥60 years) and non-elderly (＜60 years) groups based on the age at starting hemodialysis.Besides,data of gender,primary diseases,and the direct cause of death in maintenance hemodialysis patients from 1996 to 2016 were collected.Results Cardiogenic diseases,infections,and cerebrovascular accidents were the three leading causes of death.The mean dialysis age was shorter in elderly MHD patients than in non-elderly MHD patients[(51.8 ± 45.7) months vs.(81.6 ± 66.5) months,t =4.271,P=0.000]with a lower survival rate (x2 =32.422,P =0.000).The mean dialysis age was significantly lower in DN patients than in non-DN patients[(44.1±33.8) months vs.(69.4±60.6) months,t=3.632,P =0.000)] with a lower survival rate (x2 =13.361,P =0.000).The overall survival rate was 59.8％ after the fifth year of MHD,was 33.3％ after the 10th year,was 8.4％ after the 20th year,in our dialysis center.Conclusions The long-term survival rate of patients receiving maintenance hemodialysis in our center is as high as that in the developed countries and in other hospitals in Beijing.The top three death causes are cardiac diseases,infections,and cerebrovascular accidents.For old or DN patients,the overall prognosis is poor.