Analysis Of The Primary Hospital ESRD Hemodialysis Patient Survival And Causes Of Death Follow-up

Abstract:objective to basic-level hospitals end-stage renal disease patients with maintenance hemodialysis (MHD) were retrospectively follow-up, explore the MHD patients’ survival rate, the cause of death and risk factors, understanding grass-roots hospital hemodialysis patients quality of life of related factors, for the survival of basic-level hospitals and provide basis for the further improvement of the quality of life of dialysis patients. Methods between January2007and December2007, in jinan sixth people’s hospital of blood purification center line maintenance hemodialysis follow-up analysis of120patients with end-stage renal disease,120MHD patients on dialysis center different etiology such as chronic glomerular nephritis, diabetes, kidney disease, high blood pressure, kidney disease and other retrospective statistical analysis, and calculate the proportion; Statistics of120cases of MHD patients with maintenance hemodialysis time within1year,1～3years,3～5years the number of cases of survival and death cases and other cases (including lost to the number of cases, turn the pd cases, etc.), and calculate the1year,3years,5years survival rate of patients; Statistics because of heart, cerebrovascular accident, gastrointestinal bleeding, severe infection and tumor uremia complications such as the ratio of death; Calculate the different causes of death of the ratio of total death cases; Statistics in the dialysis center line maintenance hemodialysis patients with1,3,5years of relevant laboratory tests in the same data, such as Urea nitrogen (Urea), serum creatinine (Cre), serum phosphorus (P), serum calcium (Ca), hemoglobin (Hb), blood glucose (Glu), serum albumin (propagated), total cholesterol (Chol), triglyceride (TG), high-density lipoprotein (HDL) cholesterol and low density lipoprotein (LDL), may affect the quality of life of patients with statistical data processing. Results (1) in120patients with MHD primary cause analysis found that chronic glomerulonephritis (50%) is the main reason, followed by diabetes nephropathy (35%) and hypertension nephropathy (6.67%).(2) in patients with MHD number1,3,5years survival group115cases,91cases,62cases respectively;1,3,5year survival rate are95.83%,75.83%and 95.83%respectively; The blood purification center of MHD patients survival rates are negatively related with dialysis time, namely as the dialysis patients with prolonged survival rate reduced year by year. MHD patients over50years of age number1,3,5years survival group63cases,40cases,17cases respectively, the survival rate are54.78%,43.05%and54.78%respectively; Under the age of50patients with MHD group1,3,5years survival number of52cases respectively,51cases,45cases, survival rates were45.22%,56.04%and72.58%respectively. Show that MHD patients over50years of age under the age of3,5year survival rates were lower than50patients with MHD.(3) the MHD patients1,3,5years a variety of causes, the survival rate of diabetic nephropathy, lowest92.86%,59,52%and35.71%respectively; Show that diabetic nephropathy rates are highest in basic-level hospitals of MHD patients, should be taken into consideration seriously.55cases (4) the cause of death in congestive heart failure in the most rare, and there are22cases (40%). Followed by hyperkalaemia,16cases (29.10%). Cerebral hemorrhage accounted for a third, there are7cases (12.73%); Myocardial infarction, gastrointestinal bleeding, severe infection in3cases (5.45%); Tumors in1case (1.82%). Show congestive heart failure is the leading cause of death in patients with MHD.(5) according to the standard size of the partial regression coefficient, on May cause the independent risk factors of death in patients with MHD through statistical analysis, found the Hb, propagated as the protective factors of death in patients with MHD, high blood pressure, age and blood sugar of the independent risk factors of death in patients with MHD.;(6) the BMI into five sections, and mortality of each interval period of MHD patients may be calculated. By the results that, with the increase of BMI, patient mortality decreases gradually, and has good correlation (r2=0.9276);(7) by means of MHD patients plasma albumin level analysis of the correlation with mortality in patients with serum albumin level is lower, the higher mortality. Conclusion the basic-level hospital hemodialysis patients with chronic glomerulonephritis is the most common primary reason. Longer duration of maintenance hemodialysis, the survival rate of patients with reduced year by year, and in all of the follow-up of patients with diabetic nephropathy patients survival rate was the lowest. Young and middle-aged patients with MHD in dialysis first1.3.5year survival rates were higher than in elderly patients. MHD basic-level hospitals for the leading cause of death in patients with congestive heart failure, and Hb, propagated as the protective factors of death in patients with MHD, high blood pressure, age and blood sugar of the independent risk factors of death in patients with MHD. With BMI and propagated to reduce MHD patients increased mortality.