Evaluation of mortality risk factors in hemodialysis patients

AIM: The prevalence of chronic kidney disease (CKD) is increasing worldwide. In our study, we aimed to evaluate the factors that may be associated with mortality in patients who have been on hemodialysis program for at least one year. MATERIALS AND METHODS: We evaluated and retrospectively analyzed the files of 188 patients who received hemodialysis treatment for at least 1 year between 01.01.2012 and 01.10.2022 at Ondokuz Mayıs University Medical Faculty Hospital City Hemodialysis Center. The laboratory parameters of the patients at 0-3-6-9-12th months in the last one year were recorded. The changes in these laboratory parameters during the treatment and their relationship with mortality were evaluated. RESULTS: The median age of the patients was 64 (19) years and 72 (38.3%) of them were female. The median CKD duration was 108 months, hemodialysis duration was 48 months and the mortality rate was 38.8%. The most common comorbidities were hypertension (85.1%), heart disease (43.6%) and diabetes (36.2%). It was observed that mortality is increased in patients aged ≥65 years, in the presence of heart disease, low diastolic blood pressure (DBP), chlorine, vitamin D, albumin and creatinine, and high c-reactive protein (CRP) and ferritin values. The potassium values before hemodialysis and potassium variability were found low in the deceased group. CONCLUSION: In hemodialysis patients, being 65 years of age or older, presence of heart disease, low DBP, low creatinine, albumin, chlorine and vitamin D values at 12th month, and high ferritin were determined as independent variables associated with mortality. Low albumin and creatinine values, which can be the indicators of nutritional status and muscle mass of the body, have been identified as valuable markers to predict mortality in each measurement for the last 1-year follow-up. We predict that pre-hemodialysis potassium levels have a more determinant effect on mortality than post-hemodialysis measurements. Ferritin and CRP can be considered as important parameters to predict mortality in the last period.