SURVIVAL ANALYSIS OF PATIENTS ON DIALYSIS AT EKITI STATE UNIVERSITY TEACHING HOSPITAL, ADO EKITI

Abstract

The increasing incidence and prevalence of chronic kidney disease (CKD) is a serious health challenge around the world. The need to examine the longevity of sufferers under care can never be over emphasized. This study therefore investigates survival experience and factors that may contribute to longevity of CKD patient aside the treatment obtained in the Hemodialysis Centre, Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti. Records of patients on dialysis at EKSUTH were reviewed. The data were collected by complete review of patient's clinical records. Descriptive statistics were used to describe social-demographic characteristics. Kaplan -Meier survival analysis was done to assess both short and long term survival. P value of <0.05 was considered as statistically significant. The impact of six covariates on survival chances were separately investigated using Log-rank test. Also. the six covariates were further collectively examined using both Cox and Weibull models. Akaike Information Criterion was then employed for determination of a better model between them. The overall median survival time was 182 days. Only 66.3% of all the patients survived their 90th days after starting dialysis and approximately 25% survived to 366 days. Statistically significant hazard ratios for those patient with family history of chronic kidney disease was 0.45; 95% Cl 0.23 - 0.90 and for those with urinary obstruction was 0.59; 95% CI 0.35 - 0.99. Model generated imply hi(t) = -5.1499 exp {-0. 7850 Family His. Of CKDi- 0.5353 Urinary statusi} Survival rate of chronic kidney disease (CKD) patients in Ekiti State University Teaching Hospital (EKSUTH) was better than those reported in others sub-Saharan Africa, but lower than the rate from developed countries. Out of the entire explanatory variables investigated for their influence on survival chances during dialysis, only family history of chronic kidney disease and urinary status were statistically significant among variables considered. Though, age-group of patients at start of dialysis was also statistically significant when separately investigated. This study hence recommends appropriate attention to be paid to those with no family history of CKD and urinary obstruction at start of dialysis while evaluating patient for CKD.