Abstract

Chronic kidney disease remains one of the diseases with a high cardiovascular morbidity andmortality, especially when approaching the end stage. The correct timing of dialysis initiation remains a controversial issue until now. The aim of this study is to compare early and late dialysis andtheir impact on mortality. This is a retrospective study. We collected sociodemographic, clinical and biological data from the medical records of patients who reached the end stage, divided into two groups : early HDP hemodialysis with a glomerular filtration rate (GFR > 7 ml/min) and late HDT hemodialysis (GFR ≤ 7ml/min). Our study included 149 patients of whom 66 were in the HDT group. The mean age was 59.38 yearsand 64.27 years in the HDT and HDP groups respectively. The mean GFR in the HDT and HDP group was 5.4 ml/min and 9.8 ml/min. The percentages of hypertension, diabetes and coronaryi nsufficiency were respectively in HDT and HDP : 41.35%, 36.47%, 41.38% and 58.65%, 63.53%,58.62%. The main etiologies of CKD were : diabetes (26.56% HDT ; 20.73% HDP), chronic interstitial nephropathy (18.75% HDT ; 23.17% HDP), vascular nephropathy (7.8% HDT ; 4.88% HDP), chronic glomerular nephropathy (9.37% HDT ; 12.19% HDP) and indeterminate (37.5% HDT ; 30.49% HDP) Mortality in the HDT group was 34.85% (n=23) and in the HDP group 48.19% (n=40). There was no significant difference in mortality between the 2 groups (p=0.1014). In our study, mortality was slightly higher in HDP group than among HDT group, but was not significant, which requires larger studies spread over time to confirm or disprove this result.

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