PATIENT SURVIVAL STATUS AND ASSOCIATED FACTORS AMONG END-STAGE KIDNEYDISEASE PATIENTS UNDERGOING HEMODIALYSIS AT A TERTIARY HEALTHCARE FACILITY IN WESTERN KENYA

Abstract

Background: End-stage kidney disease (ESKD) is a critical health condition requiring ongoing management, often through hemodialysis. Despite advances in treatment, survival rates remain a concern. Identifying factors influencing survival can improve patient outcomes.

Aim: To assess the survival status and associated factors among ESKD patients undergoing hemodialysis at a tertiary healthcare facility in Western Kenya.

Setting: The study was conducted at a tertiary healthcare facility in Western Kenya.

Method: This was a cross-sectional study involving 174 ESKD patients who received hemodialysis between 2015 and 2021. Data on patient demographics,

clinical characteristics, laboratory results, and survival status were collected retrospectively. Unadjusted and adjusted Cox regression analyses were used to determine the relationship between various factors and survival status.

Results: Of the 174 patients, 35 (20.1%) were alive, and 139 (79.9%) had died by the end of 2021. Key factors associated with survival included treatment status, type of comorbidity, and elevated levels of calcium, sodium, and potassium. However, after adjusting for confounders, only elevated calcium levels remained statistically significant (Adjusted Hazard Ratio = 3.85, 95% CI: 1.77, 8.36; P = 0.001). The majority of deceased patients 89 (64%) died within one month of initiating hemodialysis, while 38 (27.34%) died within one to six

months.

Conclusion: ESKD patients undergoing hemodialysis in this setting experience high mortality, with treatment status and comorbidities significantly influencing survival outcomes.

Contribution: This study provides valuable insights into the survival status and factors influencing outcomes in ESKD patients undergoing hemodialysis in Kenya.