Survival and analysis of predictors of mortality in patients undergoing replacement renal therapy: a 20-year cohort
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RESEARCH ARTICLE
Open Access
Survival and analysis of predictors of mortality in patients undergoing replacement renal therapy: a 20-year cohort Emily de Souza Ferreira1* , Tiago Ricardo Moreira2, Rodrigo Gomes da Silva3, Glauce Dias da Costa1, Luciana Saraiva da Silva4, Samantha Bicalho de Oliveira Cavalier2, Beatriz Oliveira Silva2, Heloísa Helena Dias1, Luiza Delazari Borges1, Juliana Costa Machado1 and Rosângela Minardi Mitre Cotta1
Abstract Background: optimal management of end-stage renal disease (ESRD) in hemodialysis (HD) patients should be more studied because it is a serious risk factor for mortality, being considered an unquestionable global priority. Methods: we performed a retrospective cohort study from the Nephrology Service in Brazil evaluating the survival of patients with ESRD in HD during 20 years. Kaplan-Meier method with the Log-Rank and Cox’s proportional hazards model explored the association between survival time and demographic factors, quality of treatment and laboratory values. Results: Data from 422 patients were included. The mean survival time was 6.79 ± 0.37. The overall survival rates at first year was 82,3%. The survival time correlated significantly with clinical prognostic factors. Prognostic analyses with the Cox proportional hazards regression model and Kaplan-Meier survival curves further identified that leukocyte count (HR = 2.665, 95% CI: 1.39–5.12), serum iron (HR = 8.396, 95% CI: 2.02–34.96), serum calcium (HR = 4.102, 95% CI: 1.35–12.46) and serum protein (HR = 4.630, 95% CI: 2.07–10.34) as an independent risk factor for the prognosis of survival time, while patients with chronic obstructive pyelonephritis (HR = 0.085, 95% CI: 0.01–0.74), high ferritin values (HR = 0.392, 95% CI: 0.19–0.80), serum phosphorus (HR = 0.290, 95% CI: 0.19–0.61) and serum albumin (HR = 0.230, 95% CI: 0.10–0.54) were less risk to die. Conclusion: survival remains low in the early years of ESRD treatment. The present study identified that elevated values of ferritin, serum calcium, phosphorus, albumin, leukocyte, serum protein and serum iron values as a useful prognostic factor for the survival time. Keywords: Hemodialysis, Renal replacement therapy, End-stage renal disease, Chronic kidney disease; biochemical parameter
* Correspondence: [email protected] 1 Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not inclu
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