Analysis Of Death And Survival Effects Of Maintenance Hemodialysis Patients In The Early Stage Of Dialysis

Backgrands and Objective:In order to understand the basic characteristics,etiology,dialysis-related complications,laboratory biochemical indicators,vascular access and other aspects of CKD patients’early dialysis death.The cohort study on the death factors of early dialysis in hemodialysis patients was completed.The risk factors of early dialysis death were designed to determine the related risk factors causing death and improve the survival rate and quality of life of patients with uremia.The treatment plan for ESRD patients which is the first time entering hemodialysis was formulated to improve the quality of life and survival time of patients,reduce the cost of treatment and reduce the national medical burden.Methods:The data was collected from the CRF table of hemodialysis patients who were diagnosed with end-stage renal disease in the Second Affiliated Hospital of Nanchang University from June 1,2020 to December 30,2020.The general information of patients,the related information of patients with primary diseases,the information of patients’vascular access,the information of patients’hemodialysis,and the information of patients’biochemical indicators were recorded and analyzed.The Chi-square test,Rank sum test and Cox regression model was used for statistical analysis to explore the causes of early death of patients with maintenance hemodialysis and the indicators affecting their survival.Results:A total of 94 patients were enrolled in this study.According to the results of a three-month follow-up,they were divided into a survival group(82 cases)and a death group(12 cases),with a median age of 59.0 years(19-87 years).In the first three months of entering dialysis,the mortality rate was 12.77%.The top three causes of death are:cardiovascular disease,cerebrovascular disease,and infection.In comparing the survival group and the death group,it was found that the risk factors for death include:no pre-dialysis management,combining cardiac function grade IV,insufficient24-hour urine volume、elderly,higher Charlson index and FRAIL index,lower diastolic blood pressure before dialysis,higher CRP(P<0.05).In the multivariate Cox regression analysis,independent risk factors for death in early dialysis patients include:elderly(Age increases by 1 year,HR=1.096,95%CI:1.005-1.196,P<0.05),Charlson Index(increase 1 per,HR=1.286,95%CI:1.022-1.502,P<0.05),CRP(every1mg/L increase,HR=1.014,95%CI:1.002-1.025,P<0.05),combined cardiovascular disease(HR=4.378,95%CI:1.555-34.559,P<0.05),combined metabolic acidosis(HR=9.701,95%CI:1.489-95.395,P<0.05).BMI(every 1kg/m~2increase,HR=0.930,95%CI:0.717-0.997,P<0.05)is a protective factor.Conclusions:The mortality rate is higher in the three months after entering MHD.Improving the patient’s physical condition,treating comorbidities,reducing inflammation,and adjusting acid-base balance can improve the early survival rate of patients in the early stage of dialysis.