Cargando…
Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis
BACKGROUND: Chronic kidney disease (CKD) affects 10–15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the inf...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207446/ https://www.ncbi.nlm.nih.gov/pubmed/28045952 http://dx.doi.org/10.1371/journal.pone.0167895 |
_version_ | 1782490363353628672 |
---|---|
author | Magalhães, Luciene P. dos Reis, Luciene M. Graciolli, Fabiana G. Pereira, Benedito J. de Oliveira, Rodrigo B. de Souza, Altay A. L. Moyses, Rosa M. Elias, Rosilene M. Jorgetti, Vanda |
author_facet | Magalhães, Luciene P. dos Reis, Luciene M. Graciolli, Fabiana G. Pereira, Benedito J. de Oliveira, Rodrigo B. de Souza, Altay A. L. Moyses, Rosa M. Elias, Rosilene M. Jorgetti, Vanda |
author_sort | Magalhães, Luciene P. |
collection | PubMed |
description | BACKGROUND: Chronic kidney disease (CKD) affects 10–15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality. PATIENTS AND METHODS: We studied 424 patients who were admitted to our service between 01/2006 and 12/2012 and were followed for 1 year. We analyzed vascular access, risk factors linked to cardiovascular disease (CVD) and mineral and bone disease associated with CKD (CKD-MBD), and clinical events that occurred during the follow-up period. Factors that influenced patient survival were evaluated by Cox regression analysis. RESULTS: The patient mean age was 50 ± 18 years, and 58.7% of them were male. Hypertension was the main cause of primary CKD (31.8%). Major risk factors were smoking (19.6%), dyslipidemia (48.8%), and CVD (41%). Upon admission, most patients had no vascular access for hemodialysis (89.4%). Biochemical results showed that most patients were anemic with high C-reactive protein levels, hypocalcemia, hyperphosphatemia, elevated parathyroid hormone and decreased 25-hydroxy vitamin D. At the end of one year, 60 patients died (14.1%). These patients were significantly older, had a lower percentage of arteriovenous fistula in one year, and low levels of 25-hydroxy vitamin D. CONCLUSIONS: The combined evaluation of clinical and biochemical parameters and risk factors revealed that the mortality in urgent-start dialysis is associated with older age and low levels of vitamin D deficiency. A lack of a permanent hemodialysis access after one year was also a risk factor for mortality in this population. |
format | Online Article Text |
id | pubmed-5207446 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-52074462017-01-19 Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis Magalhães, Luciene P. dos Reis, Luciene M. Graciolli, Fabiana G. Pereira, Benedito J. de Oliveira, Rodrigo B. de Souza, Altay A. L. Moyses, Rosa M. Elias, Rosilene M. Jorgetti, Vanda PLoS One Research Article BACKGROUND: Chronic kidney disease (CKD) affects 10–15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality. PATIENTS AND METHODS: We studied 424 patients who were admitted to our service between 01/2006 and 12/2012 and were followed for 1 year. We analyzed vascular access, risk factors linked to cardiovascular disease (CVD) and mineral and bone disease associated with CKD (CKD-MBD), and clinical events that occurred during the follow-up period. Factors that influenced patient survival were evaluated by Cox regression analysis. RESULTS: The patient mean age was 50 ± 18 years, and 58.7% of them were male. Hypertension was the main cause of primary CKD (31.8%). Major risk factors were smoking (19.6%), dyslipidemia (48.8%), and CVD (41%). Upon admission, most patients had no vascular access for hemodialysis (89.4%). Biochemical results showed that most patients were anemic with high C-reactive protein levels, hypocalcemia, hyperphosphatemia, elevated parathyroid hormone and decreased 25-hydroxy vitamin D. At the end of one year, 60 patients died (14.1%). These patients were significantly older, had a lower percentage of arteriovenous fistula in one year, and low levels of 25-hydroxy vitamin D. CONCLUSIONS: The combined evaluation of clinical and biochemical parameters and risk factors revealed that the mortality in urgent-start dialysis is associated with older age and low levels of vitamin D deficiency. A lack of a permanent hemodialysis access after one year was also a risk factor for mortality in this population. Public Library of Science 2017-01-03 /pmc/articles/PMC5207446/ /pubmed/28045952 http://dx.doi.org/10.1371/journal.pone.0167895 Text en © 2017 Magalhães et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Magalhães, Luciene P. dos Reis, Luciene M. Graciolli, Fabiana G. Pereira, Benedito J. de Oliveira, Rodrigo B. de Souza, Altay A. L. Moyses, Rosa M. Elias, Rosilene M. Jorgetti, Vanda Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis |
title | Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis |
title_full | Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis |
title_fullStr | Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis |
title_full_unstemmed | Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis |
title_short | Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis |
title_sort | predictive factors of one-year mortality in a cohort of patients undergoing urgent-start hemodialysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207446/ https://www.ncbi.nlm.nih.gov/pubmed/28045952 http://dx.doi.org/10.1371/journal.pone.0167895 |
work_keys_str_mv | AT magalhaeslucienep predictivefactorsofoneyearmortalityinacohortofpatientsundergoingurgentstarthemodialysis AT dosreislucienem predictivefactorsofoneyearmortalityinacohortofpatientsundergoingurgentstarthemodialysis AT graciollifabianag predictivefactorsofoneyearmortalityinacohortofpatientsundergoingurgentstarthemodialysis AT pereirabeneditoj predictivefactorsofoneyearmortalityinacohortofpatientsundergoingurgentstarthemodialysis AT deoliveirarodrigob predictivefactorsofoneyearmortalityinacohortofpatientsundergoingurgentstarthemodialysis AT desouzaaltayal predictivefactorsofoneyearmortalityinacohortofpatientsundergoingurgentstarthemodialysis AT moysesrosam predictivefactorsofoneyearmortalityinacohortofpatientsundergoingurgentstarthemodialysis AT eliasrosilenem predictivefactorsofoneyearmortalityinacohortofpatientsundergoingurgentstarthemodialysis AT jorgettivanda predictivefactorsofoneyearmortalityinacohortofpatientsundergoingurgentstarthemodialysis |