4379 SURVIVAL RATES AND ANALYSIS OF PREDICTORS OF MORTALITY AMONG INCIDENT HEMODIALYSIS PATIENTS: A SINGLE CENTER FIVE-YEAR COHORT STUDY

• Published in: Nephrology, dialysis, transplantation Vol. 38; no. Supplement_1
• Main Authors: Leano, Danice Romagne, Chua, Eric, Ninalga-Rodriguez, Hazel Daphne, Danguilan, Romina
• Format: Journal Article
• Language: English
• Published: 14.06.2023
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfad063d_4379

Abstract Background and Aims Studies on improving survival rate among maintenance hemodialysis patients have been extensive. However, only a handful of studies have focused on the factors that determine mortality risk among incident hemodialysis patients, considering that the first few months of hemodialysis initiation are the most critical. Survival rates and factors predicting mortality may vary from one geographic area to another. Local data on these factors, however, are quite lacking. Identification of factors that can be optimized during this crucial period can greatly impact survival of Filipino hemodialysis patients. This study was designed primarily to determine 1-year, 3-year and 5-year survival rates of incident hemodialysis patients enrolled at the National Kidney and Transplant Institute (NKTI). Demographic and clinical factors that may influence mortality risk were identified and analyzed. Method This is a retrospective cohort study which evaluated the data of all incident adult patients enrolled at NKTI Outpatient Dialysis Unit, over a period of 5 years (January 2016 to December 2020). Patients were followed, retrospectively, from initiation until censorship (end of study, loss to follow up, transfer, conversion to peritoneal dialysis or kidney transplant) and the following factors were compared between those who remained alive and those who expired: etiology of kidney disease, age, sex, mode and frequency of dialysis, access, socioeconomic class and biochemical parameters. Descriptive statistics was used to describe and summarize the baseline data. Frequency and proportion were used for categorical variables, and median and inter-quartile range (IQR) for non-normally distributed interval/ratio variables. Survival probabilities were estimated using the Kaplan-Meier method. Cox regression was done to determine factors of overall survival. All valid data were included in the analysis. Null hypothesis was rejected at 0.05α-level of significance. Stata 15.0 was used for data analysis. Results A total of 562 incident hemodialysis patients were enrolled, 94 of whom expired. Among those who expired, there were more patients who were aged above 60 years (56.38% vs 29.91%, p <.001) and with low serum phosphorus level (29.21% vs 16.78%, p=.029) in comparison to those who were alive. Computed 1-year, 3-year, and 5-year survival rate among patients were 89.51% (95% CI 86.10% - 92.12%), 73.03 (95% CI 66.46 – 78.52%) and 42.06% (95% CI 29.52% - 54.99%), respectively. Patients who are older than 60 years (HR 2.75, p= 0.013), hepatitis C positive (HR 3.92, p= 0.021) and those with low phosphorus (HR 1.86, p= 0.015) were noted to have increased risk of mortality. Conclusion Survival rate of incident hemodialysis patients at NKTI is at par with survival estimates abroad. Risk factor identification and optimization of modifiable ones are key in improving patient survival.