Department of Nursing, College of Health Sciences, Assosa University, Assosa, Ethiopia.
Department of Psychiatry Nursing, College of Health Sciences and Referral Hospital, Ambo University, Ambo, Ethiopia.
BMC Nephrol. 2024 Aug 28;25(1):279. doi: 10.1186/s12882-024-03719-3.
Chronic kidney disease is a progressive disease that affects more than 10% of the world's population and is also the leading cause of death in the twenty-first century. Furthermore, it imposes a significant financial burden on people undergoing hemodialysis. However, there is little research, particularly in the study area, on time to death and its predicators among hemodialysis patients in Ethiopia; therefore, knowing time to death and identifying predicators that affect survival time is crucial in order to improve survival time and enhance the prognosis of hemodialysis patients. The aim of this study was to assess time to death and its predictors among patients with chronic kidney disease on hemodialysis at a dialysis unit in Addis Ababa, Ethiopia, in 2023.
An institution-based retrospective cohort study was carried out among 370 chronic kidney disease patients on hemodialysis from January 1st, 2017 to December 30th, 2022. Data were extracted from April 1st-May 20th, 2023, and each variable was coded and entered into Epi Data version 3.1 and then exported into STATA version 15 software for analysis. Kaplan-Meier and the log-rank test were done. Bivariable Cox-proportional regression was done, and a variable whose p-value was < 0.25 and fulfilled the proportional hazard assumption by using graphical and Shenfield residuals was entered into multivariable Cox-proportional regression. Finally, a variable whose p-value < 0.05 and adjusted hazard ratio with its CI were declared statistically significant predictors.
In this study, the overall median survival time was 47 months (95% CI: 36.7, 56), with an incidence rate of death of 16.8 per 1000 people per month of observation (95% CI: 13.8-20.3). Age 64 and above (Adjusted Hazard Ration: 2.8; 95% CI: 1.67-4.98), catheter vascular access (Adjusted Hazard Ration: 3.47; 95% CI: 2.03-5.93), cardiovascular disease (Adjusted Hazard Ration: 1.88; 95% CI: 1.15-3.07), and blood group B (Adjusted Hazard Ration: 2.07; 95% CI: 1.17-3.69) were significant predictors of time to death among hemodialysis patients. CONCLUSION AND RECOMMENDATION: The median survival time was 47 months, with an interquartile range of 40. Cardiovascular disease, older adults, central venous catheters, and blood type B were significant predictors of time to death for hemodialysis patients. Therefore, in order to improve the survival of hemodialysis patients, health professionals and concerned bodies should give concern to and work on those predictors.
慢性肾脏病是一种影响全球超过 10%人口的进行性疾病，也是 21 世纪主要的死亡原因。此外，它给接受血液透析的人带来了巨大的经济负担。然而，在埃塞俄比亚，特别是在研究领域，关于血液透析患者的死亡时间及其预测因素的研究很少；因此，了解死亡时间并确定影响生存时间的预测因素对于提高生存时间和改善血液透析患者的预后至关重要。本研究旨在评估 2023 年在埃塞俄比亚亚的斯亚贝巴一家透析单位接受血液透析的慢性肾脏病患者的死亡时间及其预测因素。
这是一项 2017 年 1 月 1 日至 2022 年 12 月 30 日在透析单位接受血液透析的 370 例慢性肾脏病患者的基于机构的回顾性队列研究。数据于 2023 年 4 月 1 日至 5 月 20 日提取，每个变量均进行编码并输入 EpiData 版本 3.1，然后导出到 STATA 版本 15 软件进行分析。进行 Kaplan-Meier 和对数秩检验。进行单变量 Cox 比例风险回归，然后将 p 值<0.25 且满足图形和 Shenfield 残差比例风险假设的变量纳入多变量 Cox 比例风险回归。最后，宣布 p 值<0.05 且调整后的危险比及其置信区间具有统计学意义的预测因素。
在这项研究中，总体中位生存时间为 47 个月（95%CI：36.7，56），观察期间死亡的发生率为每 1000 人每月 16.8 人（95%CI：13.8-20.3）。年龄 64 岁及以上（调整后的危险比：2.8；95%CI：1.67-4.98）、导管血管通路（调整后的危险比：3.47；95%CI：2.03-5.93）、心血管疾病（调整后的危险比：1.88；95%CI：1.15-3.07）和血型 B（调整后的危险比：2.07；95%CI：1.17-3.69）是血液透析患者死亡时间的显著预测因素。
中位生存时间为 47 个月，四分位间距为 40。心血管疾病、老年人、中心静脉导管和血型 B 是血液透析患者死亡时间的显著预测因素。因此，为了提高血液透析患者的生存率，卫生专业人员和有关机构应关注并针对这些预测因素采取措施。
