SIX-MONTH OUTCOMES OF CHRONIC HAEMODIALYSIS PATIENTS AT A TERTIARY NEPHROLOGY SERVICE IN PERTH, WESTERN AUSTRALIA
Dr Ben Tomlinson1, Dr Abu Abraham1, Dr Ramyasuda Swaminathan1
1Department of Nephrology, Fiona Stanley Hospital, Murdoch, Australia
Aim: To examine the six-month outcomes of new-start haemodialysis patients at a tertiary nephrology service in Western Australia
Background: The early period following initiation of renal replacement therapy is one of high morbidity and mortality. The data surrounding this transition is not adequately captured at a local level and may provide an opportunity for targeted service improvement.
Methods: A retrospective cohort analysis of single tertiary centre data using the electronic medical record between 1 January 2022 and 30 November 2022 for all new-start haemodialysis patients (excluding home Haemodialysis).
Results: 175 patients initiated haemodialysis during the study period. At 6-months 29 patients (16.5%) had renal recovery, 116 patients (66.3%) continued haemodialysis, 22 patients (12.5%) died (60% males, mean age 65.2 years), 4 patients (2.3%) transitioned to peritoneal dialysis, 3 patients (1.7%) received a kidney transplant, and 1 patient transitioned to home haemodialysis. The most common causes of death were infection in 9 patients (40.9%), withdrawal of dialysis in 7 (31.8%), cardiovascular disease in 2 (9.1%), and one patient died each from stroke and mesenteric ischemia.
In the cohort of 175 patients there were 177 public hospital readmissions after commencement of dialysis during the period of the study. The most common diagnoses listed on the patient discharge summary were infection (29.9%), fluid overload (11.9%), cardiovascular disease (6.8%), hyperkalaemia (3.4%), and hypotension (3.4%). 42 % of patients fell in a non-specified group which included unclear diagnosis and elective admissions.
Conclusions: Our data supports that the six-months following initiation of haemodialysis represents a high-risk period, with significant mortality and a high rate of hospital readmission. Infection stands out as a common cause of mortality and morbidity in our cohort.