Ethiopian Food, Medicine Administration and Health Care Authority, Addis Ababa, Ethiopia.
Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
BMC Nephrol. 2023 Jan 4;24(1):3. doi: 10.1186/s12882-022-03053-6.
The prevalence of chronic kidney disease (CKD) is between 10 and 15% worldwide. Ethiopia is seeing a consistent increase in the number of dialysis patients. Patients on chronic hemodialysis have high mortality rates, but there is little information available in Ethiopia. Thus, this study looked into patient mortality and the factors that contributed to it at three dialysis centers in Addis Ababa for hemodialysis patients.
A facility-based retrospective follow-up study was employed among End-Stage Renal Disease patients on hemodialysis from 2016 to 2020 at St. Paul Millennium Medical College (SPMMC), Zewditu Memorial Hospital (ZMH), and Menelik II Hospital. The proportional hazard assumption was checked by using the Log (-log (St)) plots and tests. Life-table analysis was fitted to estimate the one and five-year's survival probability of these patients and Cox Proportional regression analysis to model the predictors of mortality at p-value < 0.05.
Over the course of 2772 person-months, 139 patients were tracked. Of these patients, 88 (63.3%) were male and the mean age (± SD) of the patients was 36.8 (± 11.9) years. During the follow-up period, 24 (17%) of the patients died, 67 (48.2%) were alive, 43 (30.9%) received a kidney transplant, and 5 (3.6%) were lost to follow-up. The mean survival time was 46.2 months (95% CI: 41.8, 50.5). According to estimates, there were 104 deaths per 1000 person-years at the end of the follow-up period. The likelihood that these patients would survive for one and 5 years was 91%% and 65%, respectively. Our analysis showed that patients with hypertension (Adjusted Hazard Rate (AHR) = 4.33; 95% CI: 1.02, 34.56), cardiovascular disease (AHR = 4.69; 95% CI: 1.32, 16.80), and infection during dialysis (AHR = 3.89; 95% CI: 1.96, 13.80) were more likely to die.
The hemodialysis patients' death rate in the chosen dialysis facilities was high. Preventing and treating comorbidities and complications during dialysis would probably reduce the mortality of CKD patients. Furthermore, the best way to avoid and manage chronic kidney disease is to take a complete and integrated approach to manage hypertension, diabetes, and obesity.
慢性肾脏病（CKD）的患病率在全球范围内为 10%至 15%。埃塞俄比亚的透析患者数量持续增加。慢性血液透析患者的死亡率很高，但埃塞俄比亚的相关信息却很少。因此，这项研究调查了在亚的斯亚贝巴的三个透析中心的血液透析患者的患者死亡率及其促成因素。
采用回顾性随访研究，对 2016 年至 2020 年在圣保禄千年医科大学（SPMMC）、泽维图纪念医院（ZMH）和门利尼克二世医院接受血液透析的终末期肾病患者进行了研究。通过 Log(-log(St))图和检验检查了比例风险假设。寿命表分析用于估计这些患者的一年和五年生存率，并采用 Cox 比例风险回归分析对死亡率的预测因素进行建模，p 值 < 0.05。
在 2772 人-月的随访期间，共跟踪了 139 名患者。其中，88 名（63.3%）为男性，患者平均年龄（±SD）为 36.8（±11.9）岁。在随访期间，24 名（17%）患者死亡，67 名（48.2%）仍存活，43 名（30.9%）接受了肾移植，5 名（3.6%）失访。平均生存时间为 46.2 个月（95%CI：41.8，50.5）。根据估计，在随访结束时，每 1000 人-年有 104 人死亡。这些患者在随访结束后一年和五年的生存率分别为 91%和 65%。我们的分析表明，患有高血压（调整后的危险比（AHR）=4.33；95%CI：1.02，34.56）、心血管疾病（AHR=4.69；95%CI：1.32，16.80）和透析期间感染（AHR=3.89；95%CI：1.96，13.80）的患者更有可能死亡。
选定透析机构的血液透析患者死亡率较高。在透析期间预防和治疗合并症和并发症可能会降低 CKD 患者的死亡率。此外，避免和管理慢性肾脏病的最佳方法是采取全面和综合的方法来管理高血压、糖尿病和肥胖症。
