#4742 SURVIVAL AND PREDICTORS OF MORTALITY IN HEMODIALYSIS PATIENTS

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Abstract Background and Aims Mortality in hemodialysis patients significantly exceeds the one observed in general population. Identifying and early management of risk factors is essential for improving survival of these patients. Aim of the study is to assess survival and evaluate factors related to mortality in hemodialysis population. Method We retrospectively studied 237 patients [99 ♀, median age 76 (69-84) years] undergoing hemodialysis in a single Dialysis Center for a 10-years period of time (from 1/2/2010 to 31/1/2021). Demographics, comorbidities and laboratory parameters were recorded and analyzed. Median survival, mortality rate and factors that may affect them were evaluated. Results The mortality rate was 9.28% in the first year and 36.29% in five years after starting dialysis, respectively (Figure 1. Kaplan-Meier survival curves for the study population). Elderly patients (>65 years) had a lower median survival compared to younger ones (63 versus 103 months, p = 0.031). Survival of diabetics undergoing on-line hemodiafiltration was twice versus those undergoing hemodialysis (87 versus 42 months, p<0.001). Most common causes of death were cardiovascular diseases (32.38%), infections (20.95%) and cancer (18.1%) (p<0.001). Multivariate analysis identified as important predictors of mortality, the existence of: diabetes mellitus [hazard ratio (HR) = 2.387, 95% confidence interval (CI) 1.278-4.46, p = 0.006], peripheral arterial disease (HR = 1.875, 95% CI 1.12-3.139, p = 0.017) and central venous catheter (HR = 2.421, 95% CI 1.297-4.518, p = 0.005). In contrast, absence of vascular access thrombotic episode (HR = 0.289, 95% CI 0.158-0.527, p<0.001) and body mass index >20 kg/m2 (HR = 0.517, 95% CI 0.294-0.909, p = 0.022) had a favorable effect on survival. Conclusion Mortality rate in our cohort was measured 9.28% in first year and 36.29% in five years after starting hemodialysis. Survival was lower at elderly and diabetic patients undergoing hemodialysis. Our study identified some mortality factors potentially modifiable, such as body weight, type of vascular access and method of dialysis treatment.