Analysis of survival status and influencing factors of patients with chronic kidney disease during peri-dialysis period

Objective  To explore the survival status of patients with chronic kidney disease （CKD）, explore its influencing factors and provide research rationales for improving the survival rate of CKD patients during peri-dialysis period.

Methods  Clinical data were reviewed for 168 CKD patients during peri-dialysis period from January 1, 2019 to December 31, 2021. They were assigned into death and survival groups according to the survival outcome during follow-ups. Basic profiles, information related to primary disease, concurrent clinical symptoms and laboratory tests were compared between two groups and the risk factors for death analyzed by Logistic regression.

Results  Twenty-six deaths occurred during follow-ups, including 3 deaths not entering dialysis. When comparing general profiles between two groups, the differences were statistically significant （P＜0.05） for age （66.4 ± 13.1 vs 57.2 ± 14.3）, inclusion in CKD management （15.4% vs 36.6%）, self-care capability of daily life score （65.8 ± 9.1 vs 72.4 ± 10.2） and comorbid cardiovascular disease（50.0% vs 40.8%）; comparison of laboratory tests between two groups: 24-hour urine volume（818.2 ± 155.3 vs 1206.1 ± 197.8）, hemoglobin（76.5 ± 16.5 vs 84.7 ± 17.2）, albumin （28.8 ± 4.9 vs 34.3 ± 5.6） and C-reactive protein 29.7（7.8, 46.6） vs 10.3（1.9, 25.8） with statistically significant differences （P＜0.05）. Logistic regression analysis indicated that age ＞60 years （OR =1.647, 95%CI 1.154-6.925）, comorbid cardiovascular disease （OR= 2.573, 95%CI 1.214-8.352） and number of symptom clusters ＞3 （OR=2.715, 95%CI 1.396-6.937）were risk factors for death. Inclusion in CKD management （OR=0.894, 95%CI 0.412-0.973）, 24-hour urine output ＞800 mL（OR=0.878, 95%CI 0.358-0.953）and albumin ＞30 g/L （OR=0.926, 95%CI 0.508-0.966）were protective factors for death in CKD patients during peri-dialysis period.

Conclusions  CKD patients with during peri-dialysis period are at a higher risk of death. Incorporating CKD management, protecting residual urine volume and improving low protein status may help to improve patient survival.