Probability of survival in hypertensive and nonhypertensive patients on maintenance hemodialysis.

The actuarial survival rate for 58 unselected patients who entered a program of maintenance hemodialysis and transplantation was found to be 43.0 +/- 8.3 (SE)% for the six-year period of observation. The survival rate was considerably lower in hypertensive patients as well as in patients with familial Mediterranean fever with amyloidosis, all of whom were nonhypertensive. When the patients with familial Mediterranean fever were excluded from the non-hypertensive group, the expected survival rate of this group became greater than that of the hypertensive group, the difference being about 25% in five years and about 50% in six years. This difference in the survival rate approaches that between normotensive subjects and untreated severely hypertensive patients in the general population. It is concluded that hypertension is a serious limiting factor in the survival of patients on chronic hemodialysis, and that the difference in survival between the hypertensive and the non-hypertensive patients is attributable to hypertension.