Cargando…

Risk factors for in-hospital mortality in patients starting hemodialysis

BACKGROUND: Incident hemodialysis patients have the highest mortality in the first several months after starting dialysis. This study evaluated the in-hospital mortality rate after hemodialysis initiation, as well as related risk factors. METHODS: We examined in-hospital mortality and related factor...

Descripción completa

Detalles Bibliográficos
Autores principales: Bae, Eun Hui, Kim, Ha Yeon, Kang, Yong Un, Kim, Chang Seong, Ma, Seong Kwon, Kim, Soo Wan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608878/
https://www.ncbi.nlm.nih.gov/pubmed/26484040
http://dx.doi.org/10.1016/j.krcp.2015.07.005
_version_ 1782395733849145344
author Bae, Eun Hui
Kim, Ha Yeon
Kang, Yong Un
Kim, Chang Seong
Ma, Seong Kwon
Kim, Soo Wan
author_facet Bae, Eun Hui
Kim, Ha Yeon
Kang, Yong Un
Kim, Chang Seong
Ma, Seong Kwon
Kim, Soo Wan
author_sort Bae, Eun Hui
collection PubMed
description BACKGROUND: Incident hemodialysis patients have the highest mortality in the first several months after starting dialysis. This study evaluated the in-hospital mortality rate after hemodialysis initiation, as well as related risk factors. METHODS: We examined in-hospital mortality and related factors in 2,692 patients starting incident hemodialysis. The study population included patients with acute kidney injury, acute exacerbation of chronic kidney disease, and chronic kidney disease. To determine the parameters associated with in-hospital mortality, patients who died in hospital (nonsurvivors) were compared with those who survived (survivors). Risk factors for in-hospital mortality were determined using logistic regression analysis. RESULTS: Among all patients, 451 (16.8%) died during hospitalization. The highest risk factor for in-hospital mortality was cardiopulmonary resuscitation, followed by pneumonia, arrhythmia, hematologic malignancy, and acute kidney injury after bleeding. Albumin was not a risk factor for in-hospital mortality, whereas C-reactive protein was a risk factor. The use of vancomycin, inotropes, and a ventilator was associated with mortality, whereas elective hemodialysis with chronic kidney disease and statin use were associated with survival. The use of continuous renal replacement therapy was not associated with in-hospital mortality. CONCLUSION: Incident hemodialysis patients had high in-hospital mortality. Cardiopulmonary resuscitation, infections such as pneumonia, and the use of inotropes and a ventilator was strong risk factors for in-hospital mortality. However, elective hemodialysis for chronic kidney disease was associated with survival.
format Online
Article
Text
id pubmed-4608878
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-46088782015-10-19 Risk factors for in-hospital mortality in patients starting hemodialysis Bae, Eun Hui Kim, Ha Yeon Kang, Yong Un Kim, Chang Seong Ma, Seong Kwon Kim, Soo Wan Kidney Res Clin Pract Original Article BACKGROUND: Incident hemodialysis patients have the highest mortality in the first several months after starting dialysis. This study evaluated the in-hospital mortality rate after hemodialysis initiation, as well as related risk factors. METHODS: We examined in-hospital mortality and related factors in 2,692 patients starting incident hemodialysis. The study population included patients with acute kidney injury, acute exacerbation of chronic kidney disease, and chronic kidney disease. To determine the parameters associated with in-hospital mortality, patients who died in hospital (nonsurvivors) were compared with those who survived (survivors). Risk factors for in-hospital mortality were determined using logistic regression analysis. RESULTS: Among all patients, 451 (16.8%) died during hospitalization. The highest risk factor for in-hospital mortality was cardiopulmonary resuscitation, followed by pneumonia, arrhythmia, hematologic malignancy, and acute kidney injury after bleeding. Albumin was not a risk factor for in-hospital mortality, whereas C-reactive protein was a risk factor. The use of vancomycin, inotropes, and a ventilator was associated with mortality, whereas elective hemodialysis with chronic kidney disease and statin use were associated with survival. The use of continuous renal replacement therapy was not associated with in-hospital mortality. CONCLUSION: Incident hemodialysis patients had high in-hospital mortality. Cardiopulmonary resuscitation, infections such as pneumonia, and the use of inotropes and a ventilator was strong risk factors for in-hospital mortality. However, elective hemodialysis for chronic kidney disease was associated with survival. Elsevier 2015-09 2015-08-12 /pmc/articles/PMC4608878/ /pubmed/26484040 http://dx.doi.org/10.1016/j.krcp.2015.07.005 Text en Copyright © 2015. The Korean Society of Nephrology. Published by Elsevier. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Bae, Eun Hui
Kim, Ha Yeon
Kang, Yong Un
Kim, Chang Seong
Ma, Seong Kwon
Kim, Soo Wan
Risk factors for in-hospital mortality in patients starting hemodialysis
title Risk factors for in-hospital mortality in patients starting hemodialysis
title_full Risk factors for in-hospital mortality in patients starting hemodialysis
title_fullStr Risk factors for in-hospital mortality in patients starting hemodialysis
title_full_unstemmed Risk factors for in-hospital mortality in patients starting hemodialysis
title_short Risk factors for in-hospital mortality in patients starting hemodialysis
title_sort risk factors for in-hospital mortality in patients starting hemodialysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608878/
https://www.ncbi.nlm.nih.gov/pubmed/26484040
http://dx.doi.org/10.1016/j.krcp.2015.07.005
work_keys_str_mv AT baeeunhui riskfactorsforinhospitalmortalityinpatientsstartinghemodialysis
AT kimhayeon riskfactorsforinhospitalmortalityinpatientsstartinghemodialysis
AT kangyongun riskfactorsforinhospitalmortalityinpatientsstartinghemodialysis
AT kimchangseong riskfactorsforinhospitalmortalityinpatientsstartinghemodialysis
AT maseongkwon riskfactorsforinhospitalmortalityinpatientsstartinghemodialysis
AT kimsoowan riskfactorsforinhospitalmortalityinpatientsstartinghemodialysis