Final variables in Hemodialysis

Abstract

Introduction: The final outcomes and the surrogate end point of the treatment with chronic hemodialysis (HD) they are presented frequently without adjustments by influential factors, especially by the age. Methods: We present the final outcomes of the totality of the patients who entered to HD’s Center of Argentina with a follow-up of 24 years and we observed a significant increase in the age of the starting patients in a time. The gross mortality was in increase with the years; we compared internally for indirect standardization for age, etiology and gender and demonstrated a significant lower mortality in the period 2004-2008 that in 1988-1991 (Chi2 of 5.82; p <0.05), which had demonstrated the lowest gross mortality. Results: In external adjusted comparisons the Mortality is similar to the Argentina 2006, whereas a gross mortality rate was 47 % higher. The rates of kidney transplantation were higher (without significance) that of Argentina 2005 and 2006, when it adjusts for age; but very low if only we observe the crude rates. We did not observe conversion to positive HBsAg in the last 15 years, to positive AcHVC in the last 9 years, not to positive AcHIV in all the time. Conclusion: We conclude that it is necessary to adjust the final outcomes for influential factors, at least for age; differently it would be punished to Centers that assist aged patients. We propose to considerer final outcomes at the adjusted transplantation rate and the conversion to Hepatitis B, C and AIDS in the evaluation of the quality of the treatment.

How to cite this article:

Marinovich S. [Final variables in Hemodialysis]. Rev Nefrol Dial Traspl. 2009;29(3):94-100.