Prevalence and risk factors associated with intradialysis mortality among renal failure patients in a tertiary hospital in a developing nation

Abstract

Background: Hemodialysis is associated with potential risk of intradialysis death as a complication. We set out to determine some predialysis factors associated with intradialysis death in hemodialysis patients. Materials and Methods: We retrospectively reviewed the records of 457 patients who had hemodialysis at our facility over a 5-year period. Demographic and clinical data of patients who died during dialysis were compared with a control group made of the survivors of hemodialysis. Data was analyzed using SPSS IBM version 20. Numerical data were reported as mean ± SD. Comparison of means of continuous variables was done using student t-test. Chi square was used for comparing proportions. Multivariate logistic regression was done to determine the independent determinants of intradialysis mortality. P value < 0.05 was considered significant. Results: Of the 457 patients who had hemodialysis, 20 (4.4%) died while on hemodialysis during the review period. They were aged 47.35 ± 21.16 years (range, 16-85 years). The deceased were more likely to be elderly (P = 0.003), have pre dialysis hypotension (P < 0.004), depressed level of consciousness (P < 0.0001), predialysis pulmonary edema, and hospital admission (P = 0.047). Multivariate regression analysis identified low Glasgow coma scale (coma) as an independent risk factor for intradialysis death (P < 0.017). Conclusion: Intradialysis mortality risk is increased in a setting of elderly patients, impaired level of consciousness, pulmonary edema, and predialysis hypotension.

Keywords

• Hemodialysis
• intradialysis death
• renal failure