Factors associated with mortality in patients with chronic kidney disease

Abstract

Background: Chronic kidney disease (CKD) is a major cause of mortality worldwide. This study aimed to identify factors associated with mortality among CKD patients receiving care in the hemodialysis unit of the Douala General Hospital.

Methodology: We conducted a prospective study in the hemodialysis unit of the Douala General Hospital over a 9-month period, during which 300 patients were monitored. Sociodemographic, clinical, and therapeutic follow-up data were collected using a structured questionnaire. Univariate and multivariate logistic regressions were performed to determine factors associated with mortality.

Results: The mean age of the patients was 49.46 ± 13.87 years, ranging from 17 to 78 years. Sixty-seven patients (26%) were aged 17 to 40 years, 124 (47%) were aged 40 to 60 years, and 71 (27%) were over 60 years old. Men accounted for 60% of the patients. Additionally, 63% of the patients were married, and 41% worked in the informal sector. The average number of years on dialysis was 3 years, and the mortality rate in our sample was 14.91%. Factors significantly associated with mortality included diabetes (aOR=4.28, CI: 1.86-9.73, p<0.001), physical inactivity (aOR=11.6, CI: 4.68-30.2, p<0.001), consumption of natural products (aOR=4.68, CI: 1.79-14.0, p=0.003), and clinical symptoms such as cramps (aOR=0.06, CI: 0.01-0.38, p=0.005), anuria (aOR=4.64, CI: 1.1-18.5, p=0.03), oliguria (aOR=5.76, CI: 1.43-21.2, p=0.009), and uremic syndrome (aOR=8.96, CI: 1.62-47.6, p=0.009).

Conclusion: Reducing mortality among CKD patients requires addressing risky behaviors such as sedentary lifestyles and the use of herbal decoctions, preventing vascular access infections, and managing comorbidities.