Factors influencing survival of hemodialysis patients: data from hemodialysis center of Kaunas University of Medicine Hospital 1994–2004

We analyzed data of 383 hemodialysis patients admitted to the hemodialysis center of Kaunas University of Medicine Hospital between 1 January 1994 and 31 December 2004. The aim of the study was to estimate their survival and identify it influencing factors. Demographic data (gender, birth date), cause of renal insufficiency, date of hemodialysis (HD) initiation, blood analyses at the start of HD (hemoglobin, C-reactive protein, serum albumin, creatinine, calcium, phosphate), how HD were started (through central venous catheter or permanent vascular access), time of the first nephrologist consultation before initiating of HD were recorded for each patient in a special form. The total survival rate was estimated using the Kaplan–Maier method. Mean survival of HD patients was only 21.93 months (95% confidence intervals (CI) 18.7–25.16 months). It was influenced by a high early mortality (17.23% of patients died within the first three months from the beginning of HD (36.5% of all dead patients)). The lowest survival rate was of those patients who started HD immediately after the first consultation with a nephrologist. Early referral to nephrologist, normal serum albumin and C–reactive protein concentrations had a positive impact on survival in hemodialysis patients.