{"title":"One-year Survival of End-Stage Kidney Disease Patients Undergoing Hemodialysis in Indonesia.","authors":"Rizky Andhika, Afiatin, Rudi Supriyadi, Ria Bandiara, Lilik Sukesi, Adhika Putra Sudarmadi, Kurnia Wahyudi, Yulia Sofiatin","doi":"10.2147/IJNRD.S508012","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic Kidney Disease (CKD) represents a significant global health challenge, with Indonesia experiencing the highest surge in End-Stage Kidney Disease (ESKD) prevalence over the past decade. Kidney registries are essential for reporting health outcomes, evaluating healthcare services, advocating for policy change, and informing health infrastructure development. Survival rates in ESKD patients undergoing hemodialysis (HD) are a critical outcome measure. However, there is a lack of survival analysis data for ESKD patients receiving HD in Indonesia.</p><p><strong>Objective: </strong>This study aims to assess the one-year survival rate of ESKD patients undergoing HD in Indonesia, while examining risk factors associated with survival, including age, gender, CKD etiology, and dialysis adequacy.</p><p><strong>Methods: </strong>This analytical observational study employed a retrospective cohort design, utilizing patient data from Indonesia Renal Registry between 2016 and 2019. Kaplan-Meier survival curves were generated, and Log rank test was applied to assess the significance of survival differences across subgroups based on age, gender, CKD etiology, and dialysis adequacy.</p><p><strong>Results: </strong>A total of 122,449 ESKD patients on HD were analyzed, with a mean age of 52 years; majority (55.5%) were male, and hypertensive kidney disease was the leading cause of CKD (43.7%). The overall one-year survival rate was 91.5% (95% CI: 91.3-91.6). Survival decreased significantly with advancing age (p < 0.01), and female patients exhibited lower survival rates compared to males (p < 0.01). Patients with diabetic nephropathy had the lowest survival rate among CKD etiologies (p < 0.01). Dialysis adequacy, assessed in 11,633 patients, revealed that 69.2% had a Kt/V below 1.8. Those with inadequate dialysis had significantly lower survival rates (p=0.00015).</p><p><strong>Conclusion: </strong>The one-year survival rate for ESKD patients undergoing HD in Indonesia is 91.5%. Increased age, female, diabetic nephropathy as the underlying CKD etiology, and inadequate dialysis adequacy are associated with reduced survival rates.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"18 ","pages":"87-101"},"PeriodicalIF":2.1000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910932/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Nephrology and Renovascular Disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/IJNRD.S508012","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Chronic Kidney Disease (CKD) represents a significant global health challenge, with Indonesia experiencing the highest surge in End-Stage Kidney Disease (ESKD) prevalence over the past decade. Kidney registries are essential for reporting health outcomes, evaluating healthcare services, advocating for policy change, and informing health infrastructure development. Survival rates in ESKD patients undergoing hemodialysis (HD) are a critical outcome measure. However, there is a lack of survival analysis data for ESKD patients receiving HD in Indonesia.
Objective: This study aims to assess the one-year survival rate of ESKD patients undergoing HD in Indonesia, while examining risk factors associated with survival, including age, gender, CKD etiology, and dialysis adequacy.
Methods: This analytical observational study employed a retrospective cohort design, utilizing patient data from Indonesia Renal Registry between 2016 and 2019. Kaplan-Meier survival curves were generated, and Log rank test was applied to assess the significance of survival differences across subgroups based on age, gender, CKD etiology, and dialysis adequacy.
Results: A total of 122,449 ESKD patients on HD were analyzed, with a mean age of 52 years; majority (55.5%) were male, and hypertensive kidney disease was the leading cause of CKD (43.7%). The overall one-year survival rate was 91.5% (95% CI: 91.3-91.6). Survival decreased significantly with advancing age (p < 0.01), and female patients exhibited lower survival rates compared to males (p < 0.01). Patients with diabetic nephropathy had the lowest survival rate among CKD etiologies (p < 0.01). Dialysis adequacy, assessed in 11,633 patients, revealed that 69.2% had a Kt/V below 1.8. Those with inadequate dialysis had significantly lower survival rates (p=0.00015).
Conclusion: The one-year survival rate for ESKD patients undergoing HD in Indonesia is 91.5%. Increased age, female, diabetic nephropathy as the underlying CKD etiology, and inadequate dialysis adequacy are associated with reduced survival rates.
期刊介绍：
International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.
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