Pattern and Predictors of Intradialytic Mortality in an urban dialysis centre in South-West Nigeria: A 3-year Audit

ORIGINAL ARTICLE

Abstract

INTRODUCTION

Kidney (renal) replacement therapy is an integral component of the holistic care of patients with renal impairment. It may have adverse outcomes including intradialytic mortality. This study evaluates the prevalence as well as the factors contributing to intra-dialytic mortality in the studied population.

METHOD

A retrospective evaluation of the clinical and dialysis records of 188 adult patients who had haemodialysis in our facility over a 3-year period was performed. A comparison of clinico-demographic parameters was carried out between patients who experienced intra-dialytic mortality and those who had uneventful dialysis sessions. Data were analysed using SPSS version 24.

RESULTS

During the years under review, 14(7.4%) of the 188 patients dialysed experienced intradialytic mortality with a mean age of 40.6±16.0 years for those that died. More females died intra-dialysis compared to their male counterparts (M:F ratio = 1:3.6). The source of admission for dialysis (P=0.046), female gender (P=0.05), occurrence of intradialytic hypotension (P= 0.001), high predialytic systolic blood pressure (P= 0.039), underlying type of kidney disease (P=0.023), intra-dialytic level of consciousness (P=0.001) as well as dialysis reaction time (P=0.009) were associated with increased likelihood of intra-dialytic death. On multi-variate analysis source of admission (OD=0.000, P-value=0.998), in-patient status at last dialysis (OD=0,000, P-value=0.992), intradialytic hypotension (OD=0.000, P-value=0.980), predialytic systolic blood pressure (OD=25.431, P-value=0.981) and dialysis reaction time (OD=1696, P-value=0.981) were not predictive of mortality.

CONCLUSION

The occurrence of intradialytic mortality is dependent on predialytic as well as intradialytic factors although none of these factors exhibited predictive ability on multivariate analysis.