Predictors of mortality among incident hemodialysis patients: a cohort study (data of Russian Registry of Renal Replacement Therapy)
Abstract
Death rate is extremely high among patients on hemodialysis (HD). In order to reveal predictors of mortality we performed an analysis of the individual data of the Russian Registry of Renal Replacement Therapy. We included in analysis 2884 non-diabetic and 418 diabetic incident HD patients with completed demographic and laboratory parameters which started HD treatment between 01/01/2000 and 31/12/2005. We estimated the influence of age, sex, diagnosis as well as initial values of blood pressure (BP), hemoglobin (Hb), serum albumin (Alb) and glomerular filtration rate (GFR) separately on 1-, 2- and 3-year survival. We confirmed that age, vasculitis, pre-dialysis very low GFR (<5 ml/min), anemia (Hb <100 g/l) and hypoalbuminemia (Alb <40 g/l) increased the risk of death. The most important finding that both very low diastolic BP (£60 mm Hg) and even moderately increased systolic BP (³140 mm Hg) or increased diastolic BP (³110 mm Hg) at treatment initiation significantly impaired the long-term prognosis of life among incident HD patients. Diabetic patients had significantly impaired survival that could be partially explained by more pronounced hypertension. All revealed risk factors of death are extremely widespread in incident dialysis population and have to be ameliorated prior initiation of dialysis.
About the Authors
B. T. Bikbov
Российское диализное общество; Научно-исследовательский институт трансплантологии и искусственных органов МЗ РФ; ГКБ № 52, Московский городской нефрологический центр; г. Москва
Russian Federation
Russian Federation
N. A. Tomilina
Российское диализное общество; Научно-исследовательский институт трансплантологии и искусственных органов МЗ РФ; ГКБ № 52, Московский городской нефрологический центр; г. Москва
Russian Federation
Russian Federation
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Review
For citations:
Bikbov B.T., Tomilina N.A. Predictors of mortality among incident hemodialysis patients: a cohort study (data of Russian Registry of Renal Replacement Therapy). Nephrology and Dialysis. 2008;10(1):35-43. (In Russ.)
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