Analysis The Death Causes And Risk Factors Of Maintenance Hemodialysis Patients

Objective: In the hemodialysis center of Meishanpeople’s hospital, we analyzed the death causes and clinical datas of theend-stage renal disease (ESRD) patients with maintenance hemodialysis（MHD）, to find out the risk factors of death and increase ourawarenesses.According to the results of this study, we can adjust theclinical treatment to improve the quality and prognosis of themaintenance hemodialysis patients and extend their lives. Methods: Weretrospectively studied the cause of death of95patients with MHD in ourhemodialysis center, between January2003and December2013,as thecontrast of211patients who were survived.The treatment time of allMHD patients were more than3months.The effct of age, gender, paimarydisease of ESRD,hemodialysis frequency, body mass index (BMI),bloodpressure,albumin,prealbumin,hemoglobin,HCT,calcium,phosphorus andparathyroid hormone were analyzed. Results: Chronic glomerulonephritiswas the most common primary causes of ESRD, followed by diabeticnephropathy. The most common cause of death was cardiovasculardisease (38.95%), followed by stroke (22.11%), uremic encephalopathy,gastrointestinal bleeding, systemic failure, severe infection, et.al.Therewere53patients dead in the first year, accounting for55.8%of the total death.The first year was the peak time of death.Gender, BMI, the primarydisease, blood pressure, blood calcium and parathyroid hormone had nodifferences between the two group patients. The average age, aging (atthe age of65or higher), blood phosphorus and calcium-phosphorusproduct of death patients were higher than control group.Hemodialysisfrequency,serum albumin,prealbumin, hemoglobin,the blood cell volumeof death patients were lower than the control group.According to theresults of Kaplan-Meier life table and Cox Regression, ageing (65-year-old or higher),insufficiency dialysis(less than2times per week), lowalbumin dialysis frequency level (<35g/L), high phosphorus(>1.78mmol/L), severe anemia were the risk factors.Cox proportionalhazards regression model was adopted to analyze the multi-factor analysisshowed that: ageing patients were2.6times the risk of death;63.5%death risk would be incresed while dialysis frequency was lower than2times per week, low albumin (<35g/L) increased2.9times risk of death,39%death risk would be incresed while blood phosphorus≥1.78mmol/L,82.9%death risk would be incresed while anemia(Hb <90g/L).Conclusion: Chronic glomerulonephritis was the most common primarydisease of ESRD, followed by diabetic nephropathy. Cardiovasculardisease was the most common cause of death in maintenancehemodialysis patients, cerebrovascular disease, uremia encephalo-pathy，gastrointestinal bleeding, systemic failure and severe infection were also an important cause of death of MHD patients. The first year ofhemodialysis patients was the peak time of death.Aging, the frequency ofhemodialysis, albumin, blood phosphorus and hemoglobin could be usedas the risk factors of death in MHD patients.