Reaching Target Hemoglobin Level and Having a Functioning Arteriovenous Fistula Significantly Improve One Year Survival in Twice Weekly Hemodialysis
Reaching Target Hemoglobin Level and Having a Functioning Arteriovenous Fistula Significantly Improve One Year Survival in Twice Weekly Hemodialysis
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Date
2012-05
Authors
Hasan Abu-Aisha
Sarra Elamin
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Abstract
Introduction: This is a prospective study of a cohort of
1011 patients maintained on regular hemodialysis (HD)
in Khartoum, Sudan, studied in the year 2009 and reevaluated
one year later. Their survival rates in November
2010 were related to their baseline characteristics.
Methods: Demographic and clinical data of studied
patients was collected by direct patient interviews and
dialysis records revision. Survival rates were calculated
using the Kaplan Meier method.
Results: Patients had a median age of 45 years and a
median duration on dialysis of 25 months. Two thirds
of patients were males and 4.2% were children. Studied
patients had a one-year survival rate of 86%. Most
patients (74.8%) received twice weekly HD, and their
survival rate was lower than patients receiving thrice
weekly HD (85% versus 89%, P = 0.06). The strongest
independent predictors of mortality were lack of a
documented measure of dialysis adequacy (HR = 2.7, P =
0.00), poor functional capacity (HR = 2.4, P = 0.00), lack
of a functioning AV fistula (HR = 2.0, P = 0.00), age ≥
65 years (HR = 1.6, P = 0.02) and cardiovascular disease
(HR = 1.5, P = 0.04). Patients with hemoglobin level
< 10 g/dl had significantly lower survival rates (81%
versus 92%, P = 0.00) compared to other patients. HD
patients’ perception of their own general health was also
significantly correlated to their survival rates (P = 0.00).
Conclusion: Patients on thrice weekly HD did marginally
better than those on twice weekly HD. In the latter group,
however, having an AV fistula and a hemoglobin level
of > 10 g/dl appeared to have a positive effect on their
survival. Twice weekly HD could be acceptable for many
patients provided other aspects of renal care are cared for
adequately.
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Elamin, S. and Abu-Aisha, H., 2012. Reaching target hemoglobin level and having a functioning arteriovenous fistula significantly improve one year survival in twice weekly hemodialysis. Arab journal of nephrology and transplantation, 5(2).