Determinants of Survival among Hemodialysis Patients at Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia: A Retrospective Cohort Study

Abstract

Background: Chronic kidney disease is a common public health problem with increase the incidence and prevalence, which nearly doubled as a cause of death worldwide. However, the access to care and knowledge about the predictors of survival among hemodialysis patients is extremely limited in Ethiopia. The aim of this study is, therefore, to identify predictors of survival among hemodialysis patients. Methods: A retrospective cohort study was conducted by reviewing records of patients followed the care from 2013 to 2016 in Ayder Comprehensive Specialized Hospital, Ethiopia. Kaplan-Meier survival plots were used to calculate the crude effect on hemodialysis patients’ survival probabilities and compared using the log-rank test. Parametric survival model was used to identify predictors of the hemodialysis patient. Result: A total of 130 hemodialysis patients were followed for a median duration of 12.6 months. Hypertension and diabetes mellitus were the leading co-morbidities in hemodialysis patients. The incidence of death among hemodialysis patients was more than one per 1000 person-years of follow-up. Uremic encephalopathy and metabolic acidosis were the predominant causes of deaths, with the incidence of death 4.8 and 3.8 per 1000 person-years’ time, respectively. The multivariable log-normal regression; the lower the frequency of dialysis the survival was seen to be higher. Those who had one and two sessions per week had a significant positive effect on survival of hemodialysis patients (ARR = 1.9, 95% CI: 1.02—3.5) and (ARR= 1.3, 95% CI: 0.82-2.01), respectively. Conclusion: The incidence of death was high among patients with uremic encephalopathy and metabolic acidosis. Hypertension and diabetes mellitus were the leading co-morbidities in hemodialysis patients. Patients that undergone hemodialysis frequently were less likely to survive than their counterparts. Therefore, the focus should be made to reduce or avoid the complication of kidney diseases.

Keywords: Chronic kidney disease, hemodialysis, parametric models, survival, Ethiopia

Cite this Article

Abate Bekele Belachew, Abdukadir Nigus Mohammed, Alemayehu Bayray Kahsay. Determinants of Survival among Hemodialysis Patients at Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia: A Retrospective Cohort Study. Research & Reviews: Journal of Oncology and Hematology. 2018; 7(3): 22–29p.