Comparison between the Characteristics of Patients with Long-Term and Those with Short-Term Hemodialysis in Egypt: A Multicenter Retrospective Observational Study

Background: Chronic kidney disease (CKD) patients on hemodialysis (HD) are associated with high rates of mortality. However, to the best of the authors’ knowledge, there were no published studies concerning the long-term survival of HD patients in Egypt. Recognizing the features of long-term survivors on HD might help to plan for better HD service. The aim of the study is to identify the variables that are associated with long-term survival in Egyptian HD patients. Material and Methods: In this multicentre retrospective observational study, 73 patients who survived on HD for more than 20 years were identified from a total of 26000 patients in 25 Egyptian governorates surveyed during 2019(group 1; study group). Moreover, this study also included a comparison group (group 2) of 162 patients who passed away from June 2016 till June 2019 with an HD duration of fewer than 20 years, counted in seven HD centers (covering a total of 700 patients), that were the most accessible and cooperative ones. The demographic, clinical, dialysis, and laboratory data were retrospectively documented. Results: Male/female ratios were dissimilar in the studied groups, additionally, the distribution of possible etiology of CKD was different in the two groups. The study group had statistically significant younger age, younger age at starting HD, higher frequencies of HCV-Ab positive, and lower both systolic and diastolic blood pressures than the comparison group. Serum creatinine and albumin together with blood hemoglobin, which could be considered as a marker of better nutrition, were statistically significantly higher in long-term survival patients. Additionally, the absence of diabetes mellitus and a lower frequency of IHD were observed in the study group. The survival analysis and Kaplan-Meier curve confirmed that diabetic patients had statistically significantly lower survival estimates on HD than non-diabetics. Conclusion: Younger age and younger age at the start of HD, lower blood pressure, higher haemoglobin and serum albumin levels, adequate dialysis parameters and absence of DM were the main features of Egyptian HD patients with long-term survival.