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Abstract: SA-PO1041

Survival of Hemodialysis Patients in Saudi Arabia: A Large 4-Year Observational Analysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Abderrahim, Ezzedine, Davita Care-KSA, Riyadh, Saudi Arabia
  • Sabri, Ayman, Davita Care-KSA, Riyadh, Saudi Arabia
  • Ahmed, Mahmoud Ahmed mohamed, Davita Care-KSA, Riyadh, Saudi Arabia
  • Alobaili, Saad S., Davita Care-KSA, Riyadh, Saudi Arabia
  • Jubran, Ibrahim Abduh, Davita Care-KSA, Riyadh, Saudi Arabia
  • Dridi, Afef, Davita Care-KSA, Riyadh, Saudi Arabia
  • Al-Badr, Wisam H.A., Davita Care-KSA, Riyadh, Saudi Arabia
Background

The aim of this study was to analyze survival rates in a large cohort of patients receiving hemodialysis in 22 outpatient clinics all over Saudi Arabia (KSA) and also to identify factors influencing the risk of mortality.

Methods

We included all patients referred to DaVita-KSA clinics to continue renal replacement with hemodialysis from October 2014 to December 2018 (n=3508). Survival rates were calculated according to the actuarial method and the Cox proportional model was used to identify factors influencing mortality.

Results

Altogether 3508 patients on hemodialysis were included (54% men, 46% women) with a mean age of 52.5 ± 16.9 years. Diabetic nephropathy (40.3%) and hypertensive nephropathy (35.7%) accounted together for 75.8% of all causes of ESRD. Only 38.2% of patients had available autogenous /graft fistulae ready for use at the date of their transfer to Davita clinics vs. 65% at the last follow-up (p<0.0001). During the study period, 462 patients (13%) had been transferred to other dialysis facilities, 245 (7%) had been transplanted and 398 (11%) were deceased, representing an annual mortality rate 7.1% patients. Cardiovascular and cerebrovascular complications accounted for 49.0% of known causes of death and 14.3% were attributed to infections, while 40.4% of death causes remained unknown.
Survival rates were of 98.0, 93.9, 87.7 and 73.3% at 3, 6, 24 and 48 months, respectively. The predictors of mortality identified by multivariate regression analysis were: Older age category (RR: 3.5, 95% CI: 2.4-4.9); p< 0.0001), dialysis duration before joining Davita-KSA clinics <3 months (RR: 1.4, 95% CI: 1.1-1.7) diabetes as a cause of ESRD (RR: 1.5, 95% CI: 1.2-1.8)), and catheter as vascular access (RR: 1.4, 95% CI: 1.1-1.8).

Conclusion

Survival at 2 and 4 years was high (88% and 73%) despite a high percentage of diabetics, that the annual mortality was of 7.1% and that cardio-cerebrovascular causes accounted for about the half of known causes of deaths. Use of a central dialysis catheter was identified as a modifiable predictor of mortality. Efforts should be increased toward an early creation of, and a timely shift to, an AV fistula.