Causes and risk factors of deaths in maintenance hemodialysis patients with end-stage renal disease
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摘要: 目的 分析终末期肾病患者的死亡原因，探讨其危险因素。方法 回顾性分析2012年1月至2017年1月广西医科大学第一附属医院血液净化中心行透析治疗的患者共268例，将存活的202例作为对照组，死亡的66例作为观察组，进行相关临床指标对比分析。结果 观察组中死因为心血管疾病21例（31.8%）、脑血管疾病16例（24.2%）、感染15例（22.7%）、消化道出血5例（7.6%）、高血钾2例（3%）、原因不明7例（10.6%）。观察组的透析时间、白蛋白（Alb）、血红蛋白（Hb）、红细胞比容（Hct）、镁（Mg）、尿酸（UA）、血肌酐（SCr）均显著低于对照组，而透析开始时年龄、中性粒细胞百分比（NEU%）、中性粒细胞淋巴细胞比值（NLR）、心胸比率（CTR）均显著高于对照组，2组间差异有统计学意义（P<0.05）。Logistic回归分析提示透析开始时年龄大、营养不良、贫血、炎症状态、低Mg、低UA、低SCr及NLR、CTR比值高是维持性血液透析患者死亡的危险因素。结论 终末期肾病患者的死亡原因主要包括心脑血管疾病、感染等；透析开始时年龄大、营养不良、贫血、炎症状态、低Mg、低UA、低SCr及NLR、CTR比值高是其死亡的危险因素。Abstract: Objective To analyze the causes of deaths in maintenance hemodialysis patients and to explore the risk factors associated with deaths.Methods A retrospective analysis was performed on 268 maintenance hemodialysis cases admitted at the Blood Purification Center of the First Affiliated Hospital of Guangxi Medical University from Jan. 2012 to Jan. 2017. 202 survivors served as control group, and 66 deaths as case group. The clinical indicators were compared.Results In the case group,there were 21 cases (31.8%) of cardiovascular diseases, 16 cases (24.2%) of cerebrovascular diseases, 15 cases (22.7%) of infection, 5 cases (7.6%) of gastrointestinal bleeding, 2 cases (3%) of hyperkalemia, 7 cases (10.6%) of unknown causes. The dialysis time was significantly shorter, and albumin, hemoglobin, hematocrit, magnesium, uric acid and serum creatinine were significantly lowerin the case group than those in the control group. The dialysis starting age was significantly older, and the percentage of neutrophils, neutrophilto lymphocyteratio,cardiothoracic ratio were significantly higher in the case group than those in the control group (P<0.05). Binary logistic regression analysis showed that the advanced age, malnutrition, anemia,inflammation, low magnesium, low uric acid, low creatinine, and high neutrophilto lymphocyteratio and high cardiothoracic ratio were the risk factors for deaths.Conclusions The causes of deaths in maintenance hemodialysis patients mainly include cardiovascular and cerebrovascular diseases, infections, etc. The advanced age, malnutrition, anemia, inflammation, low magnesium, low uric acid, low creatinine,high neutrophilto lymphocyteratio and high cardiothoracic ratio were the risk factors for deaths in maintenance hemodialysis patients.
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Keywords:
- End-stage renal disease /
- Death /
- Risk factor
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