Mortalidade dos pacientes com doença renal crônica em hemodiálise de manutenção em um hospital público do Peru

Percy Herrera-Añazco, Vicente Benites-Zapata, Adrian V. Hernandez, Edward Mezones-Holguin, Manuela Silveira-Chau

The Peruvian Ministry of Health does not have a national program of hemodialysis and hospitals that offer it have coverage problems, which may result in increased mortality. We evaluated mortality of a population with incident hemodialysis in a Peruvian public hospital as well as its associated factors. Retrospective and descriptive study of a population over 18 years-old who started treatment between January 1, 2012 and December 31, 2013 with the final follow-up day on31 March 2014. We used bivariate and multivariate logistic regression models to evaluate factors associated with mortality and Kaplan Meier curves were used to determine the probability of survival. We included 235 patients with a mean age of 56.4 ± 15.8 years. Median follow-up was 0.6 years (IQR 0.3 to 1.5). 50% of years withdrew from therapy during the study for lack of financial resources or space available. The third month mortality was 37.7% (95% CI 4.7 to 48.5) and 49.5% (95% CI 5.8 to 61.4) at 7 months. There was a trend towards lower mortality when patients had more than 6 months with a diagnosis of chronic kidney disease (CKD) (OR = 0.39 [95% CI 0.12 to 1.27]) and when the patient was admitted with scheduled dialysis (OR = 0.28 [95% CI 0.01 to 2.28]). Half of patients died within seven months of follow-up. Scheduled dialysis and having longer time with CKD diagnosis tend to be associated with lower mortality.