Profiling mortality patterns and place of death in patients on maintenance hemodialysis: a retrospective study in a tertiary care academic hospital in India

被引：0
作者：
Surya Gayathri M [1 ]
Bharathi Naik [2 ]
Arun Ghoshal [1 ]
Anuja Damani [3 ]
Shankar Prasad Nagaraju [3 ]
机构：
[1] Department of Renal Replacement Therapy and Dialysis Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Karnataka, Manipal
[2] Department of Nephrology, Father Muller College of Allied Health Science, Kankanady, Mangalore
[3] Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, Manipal
[4] Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, Manipal
来源：
BMC Palliative Care | / 24卷 / 1期
关键词：
Advance care planning; End-stage kidney disease; Hemodialysis; Kidney supportive care; Mortality patterns;
D O I：
10.1186/s12904-025-01748-9
中图分类号：
学科分类号：
摘要：
Background: End-stage kidney disease (ESKD) significantly burdens healthcare systems and increases mortality. In India, approximately 175,000 individuals are relying on maintenance hemodialysis (mHD). This study aims to analyze the place of death, mortality patterns and clinical issues surrounding death in patients with ESKD undergoing mHD at a tertiary care hospital in south India. Methods: This retrospective study reviewed the medical records of 280 patients with ESKD who underwent mHD between January 2016 and April 2022. Data were collected on demographics, financial details, comorbidities, cause of death, clinical issues, and location of death. Descriptive statistics, including means, frequencies, and proportions, were used to summarize findings. Results: Among the 280 patients on mHD, there were 98 deaths. Of these, 73.5% died in hospitals, primarily in intensive care units. Of all the patient deaths, 57.7% patients who died at home and 41.6% of hospitalized patients paid out of pocket treatment expenses. Infections and cardiovascular complications were the leading causes of death. High comorbidity and symptom burden were reported, with edema, fatigue, and breathlessness being the most common symptoms. Among the hospital deaths, withholding or withdrawing life sustaining treatments was documented in only 22.2% of cases. Conclusions: Our study provides critical insights into mortality patterns and the need for improved kidney supportive care integration in patients with ESKD. Addressing symptom burden, enhancing ACP, and implementing end of life care protocols could align healthcare delivery with patient preferences, ultimately improving the quality of end of life care in this vulnerable population. Further research is recommended to explore broader interventions and their impact on patient outcomes. © The Author(s) 2025.
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