Epidemiological Investigation And Risk Factors Analysis Of Death In Patients With Maintenance Hemodialysis In Shanxi Province

Objective:Through the statistical collection of the age,gender,dialysis age,primary disease,cause of death and other epidemiological data of the death patients of maintenance hemodialysis in Shanxi Province and the results of laboratory examinations,To understand the epidemiological characteristics of the patients who died and analyze the factors related to the causes of death,to provide basic clinical data for patient management and mortality reduction.Methods:The study can be divided into three parts,The first part takes Shanxi Province hemodialysis death patients directly reported on CNRDS from January 1,2013 to December 31,2016 as the research object.An epidemiological investigation was conducted on the sex,age,dialysis age,primary morbidity,causes of death and annual mortality of the patients who died,to preliminarily understand the current situation of MHD patients in Shanxi Province.The second part retrospective analysis of hemodialysis patients registered on CNRDS on January 1,2013,solstice and December 31,2013.General data(gender,age),dialysia-related information(dialysis age,vascular access type,dialyzer type,anticoagulant),primary disease,cause of death,clinical and laboratory examination indicators(predialysis blood pressure,hemoglobin,calcium and phosphorus metabolism,albumin,etc.)were analyzed,to explore the risk factors related to patient survival.The third part analyzed the factors related to the causes of death of all the patients from 2013 to 2016 based on the abovefactors.Results:In recent years,the number of hemodialysis patients in our province has been increasing year by year.The mortality rate of hemodialysis patients shows a decreasing trend,from 7.66% in 2013 to 5.31% in 2016.The death peak is in the first three years.The primary morbidity of the first death patient has changed from chronic glomerulonephritis to diabetic nephropathy,and the main causes of death are cardiovascular and cerebrovascular events and infections.Logistic regression analysis showed that hypertensive renal damage is an independent risk factor for cardiovascular events,and high SBP before dialysis is closely related to the occurrence of cerebrovascular events,while the risk of infection in patients with primary diabetic nephropathy is 3.432 times higher than that in patients without diabetic nephropathy.Multivariate survival analysis suggested that primary disease,anemia,hypoalbuminemia,predialysis hypertension and other factors in maintenance hemodialysis patients could affect long-term survival.In hemodialysis patients,the control rate of various complications,especially renal anemia still needs to be improved.Conclusion:The mortality rate of hemodialysis patients is still high,and cardiovascular and cerebrovascular events and infections are the main causes of death of hemodialysis patients.Effective control of risk factors such as blood pressure,blood sugar,anemia and hypoalbuminemia may reduce mortality.