Long-term Outcome In 159 Cases Of Maintenance Hemodialysis

Background:Chronic renal disease and end stage renal disease are more and more popular in the world, so patients who need renal replacement therapy are increasing. The effective way of renal replacement therapy contain dialysis and renal transplantation. Because of lacking of renal donor, physiological situation, complication followed by transplantation and adverse reaction after taking immunosuppressive agents, the majority of patients depend on hemodialysis to maintain their life. The hemodialysis technique has experienced 40 years and has saved many uremia patients, but, as a therapeutic tool, the hemodialysis technique has its limits, plusing some factors of patients, The survival rate and quality of life can't attain expectant target. Some researchs have reported that the survival rate of 5 year fluctuated between 10% and 80%.Objective:To analyze the survival rate and risk factors of 159 patients with maintenance hemodialysis(MHD).According to the results of this study, we can take effective actions to improve the prognosis of maintain hemodialysis patients.Methods:We retrospectively studied the survival rate,death rate and cause of death of 159 patients with MHD between January 2004 and October 2009. The effect of age, anemia, nutritional status, dialysis time, dialysis style and eGFR to survival rate also were analyzed.Results:According to the results of life table and Cox Regression, The1 year,3 year and 5 year survival rate was 75.63%,42.21%,27.97% and death rate was 24.37%, 57.73%,72.03%. The main cause of death was heart and cerebrocascular accidents, Up to 72%, followed by infection(17.4%), disgestive tract bleeding(7%) and high potassium(3.6%). The riskfactors were severe anemia, bad nutritional status, insufficiency dialysis, monotonicdialysis style and few eGFR. Age does not affect the survival rate.Conclusion:In this group, The survival rate was apparently lower than some reports. Older age, severe anemia, bad nutritional status, insufficiency dialysis, monotonic dialysis style and few eGFR were risk factors.When the cause of death was analysed, heart and cerebrocascular accidents was the main cause.