Incidence and Predictors of mortality among chronic kidney disease patients on dialysis in Sidama region, Ethiopia: A Retrospective cohort study.

Abstract

Abstract Introduction: Chronic kidney disease is major cause of global morbidity and mortality. The upsurge of the number of patients with end stage renal disease needs attention across the globe and hence these patients are in need of renal replacement therapy. But there is paucity of information on predictors of mortality among patients on dialysis. Hence, it is important to identify those predictors of mortality in order to attempt the appropriate management. Objective To determine incidence of mortality and identify predictors of mortality among chronic kidney disease patients on dialysis at Yanet internal medicine specialized center, Hawassa, Ethiopia from September 2015 to February 2022. Methods and materials : Retrospective cohort study was conducted among chronic kidney disease patients on dialysis in Hawassa Yanet internal medicine specialized center. Data abstraction form was used to collect data from 260 patients from September 2015 to February 2022.The collected data was entered to EPI data and analyzed using STATA. Frequencies with percent, mean with standard deviation and median with interquartile range were used to describe and summarize the variables. Kaplan-Meier and log rank test were used to compare survival probability. Cox proportional hazard regression model was used to identify predictors of mortality on dialysis. Result Of the total 251 participants 176(70.1%) were male. The average age at the start of hemodialysis was 51.76 ± 13.22 (mean ± standard deviation). The incidence of mortality was 2.77 (95%CI (2.25–3.41)) per 100 person-month at risk. Age between 40–59 and ≥ 60 [AHR: 3.76; 95%CI (1.13–12.54); AHR: 5.66; 95% CI (1.72–18.66)], presence of diabetic mellitus (AHR: 1.7; 95% CI (1.08–2.70)), use of venous catheter as vascular access (AHR: 0.55; 95% CI (0.31–0.98)) were the main predictors of mortality. Conclusion This study revealed incidence of mortality and identified age, diabetic mellitus and vascular access type as significant predictors of mortality. Therefore, there should be close follow up for patients with comorbidities and choice of vascular access should be considered before hemodialysis initiation.