The Retrospective Study Of Death Cause Of Maintenance Hemodialysis

Objective: To investigate the correlative risk factors of death of chronic renal failure patients who are on maintenance hemodialysis (MHD),.Method: Retrospective analysis of all MHD from December, 1997 to December, 2007 in the First Affiliated Hospital of Dalain medical university and regular dialysis time≥3 month, there are total 91 patients in death group. Randomly selective the 126 MHD patients in the same period and same place and regular dialysis time≥3 month Statistics the index of sex, age, dialysis time, the prevalence of diabetes, whether or not emergency dialysis, systolic blood pressure(SBP), diastolic blood pressure(DBP), body mass index(BMI), urea nitrogen(Urea), serum creatinine (Cre),hemoglobin(Hb), albumin(Alb), glucose(Glu),serum calcium(Ca), phosphorus(P), cholesterol (Chol), triglyceride(TG), high density lipoprotein cholestero (HDL-ch), low density lipoprotein cholesterobin(LDL-ch) and so on, firstly carry on the one way analysis, and use the significative index (P<0.05) to carry on the Mul-variabl non-conditional logistic regression analysis , study the correlative risk factors of denth.By utilizing analysis of varianc to analysis the basic data among the group of diabetes,non-diabetes and the normal fasting blood glucose, and non-diabetes and the impaired fasting glucose, andχ2 test to analyze the death relationship of IFG and MHD patients.Result:1.The cause of chronic renal failureDeath group: hypertension nephropathy (26.4%), diabetic nephropathy (30.8%),chronic glomerulonephritis (19.8%), obstructive nephropathy (4.4%), lupus nephropathy(LN) (1.1%), nephrotic syndrome(NS) (3.3%), chronic mesenchymal nephropathy (2.2%), ploycystic renal disease (1.1%), and else (11.0%)Survival group:hypertension nephropathy(19.8%), DN(19.0%), chronic glomerulonephritis(38.1%), obstructive nephropathy(1.6%), LN(2.4%), NS (0.8%), chronic mesenchymal nephropathy(2.4%), ploycystic renal disease (7.9%), and else(7.9%).2.The death reason of MHD patients are cardiovascular disease(44 patients), Seriously infection(34 patiengts), Bleeding(18 patients), Malnutrition(18 patients), Tumor(15 patients), Uremic encephalopathy(8 patients).There are 50 MHD patients who have one reson of death,36 MHD patients have two and 5 patiens have three. cardiovascular disease is the mainly reason of death on MHD patients.3.One way analysis of MHD patients between death group and survival group shows that age, the prevalence of diabetes, dialysis time, SBP ,DBP, Hb, Glu, Alb, HDL-ch total 9 variables have statistics difference (P<0.05). The mul-variabl non-conditional logistic regression analysis shows that Hb, Alb,HDL-ch are protective factors of MHD patients, SBP, age,Glu are risk factors of MHD patents.4.The MHD patients are divided into five interval paragraphs according to BMI value,then calculate the death rate of every interval paragraph.We find that BMI is negative correlation with the death of MHD patients.5.The MHD patients are divided into six interval paragraphs according to Alb value,then calculate the death rate of every interval paragraph.We find that Alb is negative correlation with the death of MHD patients.6.The one way analysis of MHD patients among the group of diabetes, non- diabetes and the normal fasting blood glucose and non-diabetes and the impaired fasting glucose shows that the diffents of age, dialysis time, Cre, P, Alb, TG, Chol have statistics difference between diabetes and non-diabetes and the normal fasting blood glucose, age, dialysis time, DBP Urea, Ca, Alb, Cre have statistics difference between diabetes and non-diabetes and the impaired fasting glucose, age, DBP,Urea, Ca,Cre have statistics difference between non-diabetes and the normal fasting blood glucose and non- diabetes and the impaired fasting glucose. But carry on theχ2 test between death and survival in the three groups and find the death rate of diabetes group is 56.4% , non-diabetes with the normal fasting blood glucose group is 53.3%,and non-diabetes with the impaired fasting blood glucose group is 33.3%,there is Significant difference.Conclusion:1. Hb, Alb, HDL-ch are protective factors of MHD patients. SBP, Age, Glu are risk factors of MHD patients. 2.BMI,Alb are negative correlation with the death of MHD patients.3.The impaired fasting glucose can independently predict the death of MHD and non-diabetes patients.