Analysis Of Cause Of Death In Maintance Hemodialysis Patients

ObjectiveTo analyze the cause of death and its correlated risk factors in maintance hemodialysis patients so as to help to reduce mortality and improve quality of life in MHD patients.MethodsWe select 50 dead patients who accepted MHD in Shandong Provincial Hospital from January, 2003 to January, 2008 to analyze. Also, we use 50 alive patients as contrast. All the patients were told to restrict water and salt, and accepted all the supportive treatments, such as regulating the blood pressure or blood sugar, anemia treatment and so on.Results(1) The top 3 primary disease of MHD patients are Diabetic Nephropathy (DN) 19 cases (38%), Chronic Glomerular Nephritis (CGN) 10 cases (20%) and Benign Arteriolar Nephrosclerosis 9 cases (18%). The following primary disease in the order of cases are Aristolochic Acid Nephropathy 4 cases (8%), Malignant Hypertension 2 cases (4%), Obstructive. Nephropathy 1 case (2%), Polycystic Kidney Disease 1 case (2%), Lupus Nephritis 1 case (2%), Kidney Tuberculosis 1 case (2%), Chronic Pyelonephritis 1 case (2%), Gouty Nephropathy 1 case (2%).(2) The treatment time before MHD is 0-91 months, 21.27±27.55 months in average. The time for MHD is 1-44 months, 12.89±13.32 months in average. They have no correlation, y=0.026 (P=0.895) .(3) The cause of death in 50 cases MHD patients are heart failure or arrhythmia 16 cases (32%), cerebral vascular accident (CVA) 12 cases (24%), severe infection 5 cases (10%), quit MHD because of economic reason 5 cases (10%), terminal tumor 4 cases (8%), multiple organ dysfunction syndrome(MODS) 2 cases (4%), digestive tract hemorrhage 2 cases (4%), quit MHD because of other reasons 2 cases (4%), suicide 2 cases (4%).(4) The serum phosphorus and the product of calcium and phosphorus are higher in death cases than in alive cases, and the hemoglobin, glomerular filtration rate and medicare rate are lower(p<0.05).(5) The logistic regression demonstrates that hemoglobin, serum phosphorus, glomerular filtration rate and medicare type are the correlated factors to the death(p< 0.05).DiscussionThe main causes of death in MHD patients are cardiovascular accident, cerebral vascular accident, severe infection and economic reason. Serum phosphorus, glomerular filtration rate and medicare type are important influencing factors to the prognosis of MHD patients.