Mortality Rates and Risk of Death Recorded After 12 Months

2.3. Mortality rate and risk of death recorded after 12 months

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Overall mortality rate of the two study subjects: 8.5% (9.66% for periodic hemodialysis and 3.85% for continuous ambulatory peritoneal dialysis) (with p > 0.05).

Survival rate and risk of death according to BMI after 12 months of follow-up: Severe malnutrition caused 37.5% mortality; serum albumin < 35 caused 16.3% mortality and nPCR < 0.8 caused 38.89% mortality and when nPCR > 1.2 caused 9.85% mortality.

Multivariate regression analysis including nPCR (g/kg/day), serum albumin, serum prealbumin and serum protein related to mortality after 12 months, found that serum albumin concentration was related to mortality and had statistical significance (with p = 0.018): Multivariate regression equation.

Mortality rate (Y) = 0.133 x serum albumin – 0.035.

SOME LIMITATIONS OF THE STUDY

The research characteristics of the two groups of chronic kidney disease patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis were not consistent. The number of research subjects of chronic kidney disease patients undergoing hemodialysis was four times higher than that of the group of patients undergoing continuous ambulatory peritoneal dialysis.

Can Tho General Hospital still has many difficulties in terms of professional human resources, facilities and equipment are still limited and inadequate. Therefore, some indicators related to blood filtration efficiency have not been implemented, some clinical and paraclinical indicators due to complications of end-stage chronic kidney disease as well as blood filtration have not been evaluated such as: bone and joint diseases, cardiovascular complications, β-globulin, Parathyroid hormone (PTH), cytokines...

The study has not analyzed and evaluated the group of patients who died at home due to many objective factors such as: economic conditions are mostly very poor, the geography of the hometown is far from the hospital, low cultural level and limited awareness, and difficult means of communication.

PROPOSAL

1. The higher the rate of malnutrition is associated with increased mortality in patients with end-stage renal disease undergoing renal replacement therapy, nutritional assessment using blood biochemical tests such as: Albumin HT, leptin HT or nPCR should be performed more frequently to limit the rate of malnutrition in the future for patients undergoing renal replacement therapy.

2. More attention should be paid to the nutritional status of patients with end-stage renal disease undergoing renal replacement therapy, in order to have nutritional interventions to limit the risk of death in this group of patients.

LIST OF PUBLISHED RELATED SCIENTIFIC WORKS

1. Vo Thanh Hung, Hoang Bui Bao (2011), N-Terminal Pro Brain Type Natriuretic Peptide (NT-ProBNP) concentration in patients with end-stage chronic renal failure. Published, Practical Medicine (June 2011), No. 769 + 770, ISSN 1859-1663. pp.495-501.

2. Vo Thanh Hung, Hoang Bui Bao, Cao Minh Chu (2017), Evaluation of the treatment effectiveness of continuous ambulatory peritoneal dialysis in patients with end-stage chronic kidney disease after 6 months of implementation at the nephrology department of Can Tho City General Hospital (from April 2016 to October 2016). Published, Vietnam Journal of Internal Medicine (April 2017). pp.292-296.

3. Vo Thanh Hung, Hoang Bui Bao, Cao Minh Chu (2017), Survey of nutritional status according to SGA_3 score in patients with end-stage chronic kidney disease undergoing regular dialysis. Published, Vietnam Journal of Internal Medicine (April 2017). pp.297-301.

4. Vo Thanh Hung, Hoang Bui Bao, Cao Minh Chu (2017), Study on the correlation between serum leptin concentration and left ventricular mass index in patients with end-stage chronic kidney disease undergoing hemodialysis. Published, Vietnam Journal of Cardiology, No. 79, July 2017. pp. 110-117.

5. Vo Thanh Hung, Hoang Bui Bao, Cao Minh Chu (2017), Study on the correlation between nutritional status and protein degradation rate in patients with end-stage chronic kidney disease undergoing hemodialysis. Published in Journal of Medicine and Pharmacy - Hue University of Medicine and Pharmacy, volume 7, number 5 (November 2017), pp.132-137.

6. Vo Thanh Hung, Hoang Bui Bao, Cao Minh Chu (2017), Assessment of nutritional status in patients with end-stage chronic kidney disease undergoing hemodialysis. Published, Journal of Medicine and Pharmacy - Hue University of Medicine and Pharmacy, special issue (August 2017), pp.478-483.

7. Vo Thanh Hung, Hoang Bui Bao, Cao Minh Chu (2017), Collaborators for the topic. “Patient satisfaction using medical services at public hospitals in Can Tho city. Published, Journal of Medicine and Pharmacy - Hue University of Medicine and Pharmacy, volume 7, number 5 (November 2017), pp.138-145.

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ENGLISH

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