Department of Nephrology, College of Medical Sciences Teaching Hospital, Bharatpur, Nepal.
Department of Community Medicine, College of Medical Sciences Teaching Hospital, Bharatpur, Nepal.
Kathmandu Univ Med J (KUMJ). 2020;18(69):9-14.
Background Maintenance hemodialysis is a popular treatment modality of renal replacement therapy for end stage renal disease patients; however their mortality seemed to be rising in our centre. There were no previous studies regarding the clinicodemographic profile and outcome of maintenance hemodialysis patients from this region. Objective This study was carried out with an objective to know the clinicodemographic profile and outcome of maintenance hemodialysis patients in our centre. Method This study was a hospital based prospective observational study carried out over a period of three year, from May 2016 to April 2019, in the hemodialysis unit of the department of nephrology. All the consecutive end stage renal disease patients on maintenance hemodialysis were included in the study. The patient's demographic profile and outcome were studied and analysed using appropriate statistical tools. Result A total of 156 patients were enrolled in the study. Males were 96(61.5%) and females were 60(38.5%). The mean age of the patient was 52.2±15.6 years. The commonest causes of end stage renal disease and reasons for admission were Type 2 diabetes mellitus 68(43.6%) and volume overload with heart failure 101(64.7%) respectively. At the end of three years, 39(25%) were expired, 14(8.9%) were transferred to other centre and four (2.6%) underwent kidney transplantation. The average duration of hemodialysis was 20.3± 17.5 months. Majority of the patients 154(98.7%) had repeat admission ranging from 1 time 21(13.5%) to 10 times two (1.3%). There was a significant association between age ≥ 40 years and diabetes with mortality (p value < 0.003 and < 0.028 respectively). Conclusion The commonest cause of end stage renal disease and the reason of admission were Type 2 diabetes mellitus 68 (43.6%) and volume overload with heart failure 101 (64.7%) respectively. The overall mortality was 39 (25%) and the commonest cause of mortality was sepsis/health care associated pneumonia 30 (76.9%). There was significant association between age ≥ 40 years and diabetes with mortality (p value < 0.003 and < 0.028 respectively).
维持性血液透析是终末期肾病患者肾脏替代治疗的一种流行治疗方式；然而，在我们中心，他们的死亡率似乎在上升。以前没有关于该地区维持性血液透析患者的临床和人口统计学特征及结局的研究。目的：本研究旨在了解我们中心维持性血液透析患者的临床和人口统计学特征及结局。方法：这是一项基于医院的前瞻性观察性研究，于 2016 年 5 月至 2019 年 4 月在肾脏病科血液透析室进行，纳入了所有连续接受维持性血液透析的终末期肾病患者。使用适当的统计工具研究和分析患者的人口统计学特征和结局。结果：共有 156 名患者纳入研究。男性 96 例（61.5%），女性 60 例（38.5%）。患者的平均年龄为 52.2±15.6 岁。最常见的终末期肾脏病病因和入院原因分别为 2 型糖尿病 68 例（43.6%）和心力衰竭伴容量超负荷 101 例（64.7%）。3 年后，39 例（25%）患者死亡，14 例（8.9%）患者转至其他中心，4 例（2.6%）患者接受了肾脏移植。平均血液透析时间为 20.3±17.5 个月。大多数患者 154 例（98.7%）有重复入院，1 次入院 21 例（13.5%），10 次入院 2 例（1.3%）。年龄≥40 岁和糖尿病与死亡率之间存在显著相关性（p 值分别<0.003 和<0.028）。结论：最常见的终末期肾脏病病因和入院原因分别为 2 型糖尿病 68 例（43.6%）和心力衰竭伴容量超负荷 101 例（64.7%）。总的死亡率为 39 例（25%），死亡率最高的原因是脓毒症/与卫生保健相关的肺炎 30 例（76.9%）。年龄≥40 岁和糖尿病与死亡率之间存在显著相关性（p 值分别<0.003 和<0.028）。
