Mohammad Saleem, Irtiqa Rehan, Mohammad Asim Rana, Aftab Ahmad, Maryam Asif, Fahad Mehmood, Mohammad Ahad Qayyum.
Early Mortality Rate in patients Initiating Maintenance Hemodialysis in a Tertiary Care Hospital.
Pak J Kidney Dis Jan ;4(3):294-7.

Background and Aims: Mortality of end stage renal disease patients is 10 to 30 times higher than that of the general population. Timing of death related to dialysis vintage remains unclear. Mortality risk among hemodialysis patients may be highest soon after initiation of hemodialysis, the reason for which remains elusive. This study was carried out to determine the early mortality rate i.e. 90 day mortality in patients starting maintenance hemodialysis at a tertiary care facility in Pakistan. Poor planning for dialysis initiation is known to be associated with hemodialysis catheter use, more infections and a higher mortality. This study additionally reports early mortality rate based on the type of vascular access used to initiate hemodialysis. Method: This is a cross sectional study which included all consecutive patients who initiated maintenance hemodialysis at Bahria Town International Hospital Lahore over a three-month period. Each patient was followed up for a period of 90 days and the type of vascular access used to initiate hemodialysis was noted. Early mortality rate i.e. 90-daymortality rate from the day of initiation of dialysis was calculated. All collected data was analyzed using the SPSS software. Results: A total of 485 participants were included in the study. The mean age was 44years while 51% of the participants were male. The 90 day (early) mortality rate of patients initiating maintenance hemodialysis at our centre was found to be 45%. 88% of the patients initiated maintenance hemodialysis using a temporary hemodialysis catheter.48% of the patients starting maintenance hemodialysis through a temporary dialysis catheter died within the 3 months of study period. Conclusion: The90-day (early)mortality rate is significantly high i.e. 45% in patients initiating maintenance hemodialysis. The use of temporary hemodialysis catheter to initiate maintenance hemodialysis is a major risk factor for early mortality when compared to AVF use.

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