Author(s): Branco, Carolina ; Gameiro, Joana ; Costa, Cláudia ; Silva, Bernardo ; Peres, Nadiesda ; Sant'Ana, Mariana ; Fonseca, José ; Outerelo, Cristina ; Resina, Cristina ; Lopes, José
Date: 2024
Origin: Portuguese Kidney Journal (PKJ)
Subject(s): Kidney Failure, Chronic; Renal Dialysis/mortality; Renal Insufficiency, Chronic; Vascular Access Devices
Introduction: Portugal has one of the highest incidences and prevalence of end‐stage kidney disease in Europe, with haemodialysis (HD) being the most common modality of renal replacement therapy. The aim of our study was to analyse a cohort of patients who started HD in a large tertiary care hospital. Methods: Retrospective analysis of all adult individuals who started HD between January of 2014 and December of 2019 in Centro Hospitalar Universitário Lisboa Norte. The primary outcome was mortality. Statistical significance was defined as a p‐value <0.05. Results: We included 1122 patients (mean age 64.9 ±16.8 years, 21.2% at least 80 years old; 60.9% male; 79.7% cau‐ casian). At HD start, mean eGFR was 8.98 ±5.66 mL/min/1.73 m2 and the vascular access was a central venous catheter in 56.0%.The percentage of elderly patients increased throughout the years (p=0.029) and HD was started with progressively lower eGFR (p<0.001). The percentage of patients with central venous catheter increased (p<0.001).In total 392 patients died (7.5% within the first 90 days). Mortality rate within the first year declined over time (p<0.001). Conclusion: Despite the increase in elderly patients, mortality within the first years declined, highlighting the quality of care provided, in addition to better acknowledgment and referal to conservative care.
