Analysis of causes of death in elderly patients undergoing maintenance hemodialysis

Abstract

Objective To analyze of causes of death in elderly patients undergoing maintenance hemodialysis (MHD) and their major risk factors. Methods A total of 105 patients aged ≥60 years under MHD treatment for more than 3 months from Jun 2010 were included with complete basic registration information in this retrospective cohort study. The deadline of the follow-up was 30 Jun 2013. Results Among 105 patients, the median age was 69 years and the median dialysis duration was 27 months. 33 patients died during the follow-up period. The main causes for death were cardiovascular disease (11 cases, 33.3%), infection (7 cases, 21.2%) and cerebrovascular disease (5 cases, 15.2%). Age and the proportion of patients with cardiovascular diseases and peripheral vascular calcification score were higher, and the proportion of hypertension patients was lower in death group than in survival group. After adjusting for age, body mass Index, kt/v, and calcification score, COX regression analysis indicated that complications with cardiovascular disease (HR=2.143, 95% CI: 1.010~4.613, P=0.049), without hypertension (HR=0.293, 95% CI: 0.097~0.889, P=0.03), and with lower serum level of albumin (HR=0.838, 95% CI: 0.748~0.904, P=0.002) were the main risk factors for mortality in elderly patients on MHD. Conclusions The main causes for death in elderly MHD patients are cardiovascular disease, infection and cerebrovascular disease. Malnutrition and the comorbidity of cardiovascular disease might be the main risk factors for mortality in elderly MHD patients. Key words: Hemodiafiltration; Cause of death