Survival Pattern of Patients on Maintenance Haemodialysis for End Stage Renal Disease in a Nigerian Dialysis Centre

Author(s): Dada SA, Inubile AJ, Thomas AA, Dada OE, Akinyemi RO

Background: The increasing incidence and prevalence of chronic kidney disease (CKD) is a serious health challenge globally. The need to examine the longevity of patients with CKD can never be over emphasized. We investigated the survival experience and factors that may contribute to the longevity of chronic kidney disease patient on haemodialysis.

Methods: Data for the study were extracted from the record of CKD patient on haemodialysis. Kaplan-Meier survival analysis was done to assess both short- and long-term survival. The impact of six covariates on survival chances were separately investigated using Log-rank test and collectively examined using both Cox and Weibull models. Akaike Information Criterion was then employed for determination of a better model between variables. P-value of <0.05 was considered as statistically significant.

Results: The overall median survival time was 182 days. Only 66.3% of all the patients survived their 90th days after starting dialysis and approximately 25% survived to 366 days. The hazard ratios for those patients with family history of chronic kidney disease was 0.45; 95% CI 0.23-0.90 and for those with urinary symptoms was 0.59; 95% CI 0.35-0.99. Model generated imply hi(t)= –5.1499 exp{–0.7850Family His. Of CKDi –0.5353Urinary symptomi}. The age of the patient was also found to be statistically significant when separately investigated.

Conclusion: Family history of chronic kidney disease and urinary symptoms were found to influence the survival of patients on haemodialysis. Early identification of at-risk family and prompt treatment of urinary symptoms is advocated.