Analysis of risk factors for adverse outcomes in HIV/AIDS patients with ESRD undergoing hemodialysis: a cohort study.

Abstract

Background: Infection is the second leading cause of death and hospitalization in hemodialysis (HD) patients. The occurrence of infections in HIV/AIDS patients with End-Stage Renal Disease (ESRD) undergoing maintenance hemodialysis is influenced by patient characteristics and related treatment regimens. Currently, there is limited data both domestically and internationally on the risk factor analysis for adverse outcome following infections in HIV/AIDS patients with ESRD receiving maintenance hemodialysis. This study aims to identify the risk factors associated with adverse outcomes following infections during hemodialysis in patients with HIV/AIDS and ESRD.

Methods: In this retrospective cohort study, we evaluated the 9-month treatment outcomes of 70 HIV/AIDS patients with ESRD and concurrent infections undergoing maintenance hemodialysis at a hospital in Guangxi between January 2019 and December 2024. The patients were divided into adverse outcome group(defined as mortality or severe complications leading to prolonged hospitalization) and survival group. Data analysis was performed using IBM SPSS Statistics version 26.0, with statistical significance set at P ≤ 0.05, to identify adverse outcome risk factors for concurrent infections in HIV/AIDS patients with ESRD.

Results: Among the 70 enrolled patients, the age ranged from 11 to 86 years. Adverse outcomes occurred in 48 cases (68.57%), while 22 patients (31.43%) survived without severe events. Multivariate analysis identified low-level hemoglobin(HB)(OR 0.952(95%CI 0.908,0.998),P = 0.042) and platelet (PLT)(OR 0.987(95%CI 0.975,1.000),P = 0.046).

Conclusion: Adverse outcomes are common among HIV/AIDS patients with ESRD who develop infections during maintenance hemodialysis. Low hemoglobin and low platelet levels are significant risk factors for poor prognosis in this patient population. Early identification and management of these hematologic abnormalities may help improve clinical outcomes.