Survival Rate and Associated Risk Factors in Hemodialysis Patients

Background: and aim: The incidence of End-stage of kidney disease (ESRD) is increasing substantially. According to official reports in Iran, the annual rate of increase in the ESRD is 11%, and evidence shows that the number of patients in the next 5 years will double. The current study aims to assess the survival rate and its predictors in hemodialysis patients. Methods: : Retrospective single-center analysis was performed using data from educational Hospitals affiliated with the faculty of medicine of Abadan University of Medical Sciences (southwestern region of Iran) from Jan 2002 to Dec 2017. Data were collected from patients' demographic records and patients' clinical records. The patient survival period was plotted using the Kaplan-Mire survival curve. Using a leg-rank test, we compared the median survival rate among the levels of the factors studied. Also, the Cox regression model was used to study the effect of the same variables on the desired time. Results: : Overall, 389 patients were enrolled in the study, of which 216 (55.5%) were men and 173 (44.5 %.) were from urban residences. Seventy-nine percent were married and 229 (60.1%) patients were illiterate. The probability of patients’ one, five, and ten years of survival were 0.92, 0.46, and 0.02, respectively. The Cox regression model shows that the risk of death in hemodialysis patients with high blood pressure is 1.45 times higher than in those without hypertension (P < 0.01). On the other hand, factors such as rural residence (P <0 .05), older age (P< 0.01), Permanent Catheter (P < 0.05), and high serum creatinine (P < 0.05) and BUN level (P<0.01) increase adjusted hazard ratio in hemodialysis patients. Conclusion: Our study explored the mortality and associated risk factors in Iranian dialysis patients from the Southwestern region. We found that the cumulative hazard of mortality was significantly higher in hemodialysis patients than in those with other types of renal failure after adjusting for various confounders. The increased risk of death in hemodialysis patients could be due to their inadequate, inconvenient, or inappropriate access to healthcare services. Further studies are necessary to devise preventive and national strategies for hemodialysis patients.