Mortality in patients with chronic renal failure during the first 90 days of hemodialysis therapy

Abstract

A retrospective cohort study was made, in which patients with terminal chronic renal failure (TCRF) were followed out during 90 days and entered to the periodical hemodialysis program in four renal units in Bucaramanga between January 1st and December 31st, 2002. 119 patients were included, from which five lost the follow-up. 20 patients died (17.54% IC95% 10,46-24,64).

The average age was 53 years (range 17-86). 70.59% were men. 84.03% of the patients were in-hospital when they started the treatment and the rest were ambulatory. The hemodialysis started in 90.76% with temporal catheter and only 9.24% had arteriovenous fistula. The most frequent causes of TCRF were: diabetes mellitus (46.22%), arterial hypertension (20.17%), Chronic Glomerulonephritis (10.08% and obstructive nephropathy (6.72%). Four factors were associates to the increase in 90 days-mortality risk: Serum albumin < 3.5 g/dl (RR = 7.91, IC95% 1.06 ­ 58.89); age > 60 years old (RR = 2.90, IC95% 1.19 ­ 7.07); catheter-associated sepsis (RR = 2.44, IC95% 1.09 ­ 5.47); and to have more than five comorbidities (RR = 2.44, IC95% 1.10 ­ 5.38).

In the multivariable analysis of the logistic regression only the albumin < 3.5mg/dl (OR = 20.47 IC95% 2.0 ­ 209.2) and the age 60 years old (OR = 9.65 IC95% 1.77 ­ 52.58) kept and independent association with mortality.