THE SURVIVAL AND FACTORS AFFECTING SURVIVAL, IN HEMODIALYSIS PATIENTS

This study is performed in Istanbul University Cerrahpaşa Medical Faculty Haemodialysis Unit. 172 patients (mean age 45 years; 109 males, 63 females) regularly dialysed for at least longer than 3 months in our unit between the years 1989 and 2001 were studied. The aim of the study was to find the survival and the factors affecting the survival of the patients. The aetiology of ESRD was unknown in 59 (%34.3) patients, glomerulonephritis in 22 (12.8%) patients, diabetic nephropathy in 21 (12.2%) patients, hypertension in 17 (9.8%) patients, interstitial nephritis in 16 (9.3%) patients, systemic vasculitis in 10 (5.8%) patients, amyloidosis due to familial mediterranean fever in 9 (5.2%) patients, obstructive nephropathy in 5 (3%) patients, polycystic kidney disease in 5 (3%) patients and miscellanous in 8 (4.6%) patients. Age, sex, dry weight, BM1 (kg/m2 ), time of hemodialysis and socioeconomic status constituted patient characteristics evaluated. Karnofsky performance score, cooperation, postdialysis serum albumin level, systemic arterial pressure (mean predialysis and postdialysis systolic and diastolic blood pressure and mean arterial pressure), co-morbidity (CVS, CNS, peripheric vessel disease, neoplastic diseases) and laboratory results (mean hematocrit, total cholesterol, LDL, calcium, inorganic phosphorous, ALP, iPTH, urea, creatinine values) were also included in the analysis. Parameters related to dialysis efficiency (Kt/V, URR) were calculated. Kaplan-Meier Method was used to calculate the survival, Cox-Regression Hazard Model was used to find out the factors affecting the survival significantly. Five and 10 year survivals were calculated to be 42% and 25.3% respectively. Age (OR=9.2), Karnofsky performance score (OR=8.5), predialysis mean arterial pressure (OR=5.4), mean albumin level (OR=5), predialysis mean diastolic blood pressure (OR=4.7), mean creatinine (OR-4.3), cardiovascular morbidity (OR=2.1), mean hematocrit level (OR=2), postdialysis mean diastolic blood pressure (OR=2) and mean Kt/V (OR=1.2) were the factors affecting the survival significantly.