Abstract Background Emergency hemodialysis is frequently initiated under critical conditions and is associated with high short-term mortality and variable need for recurrent dialysis. However, predictors of these outcomes in patients undergoing first-time hemodialysis in the emergency department are not well defined. This study aimed to identify clinical and laboratory factors associated with one-month mortality and recurrent dialysis requirements. Method This prospective observational study included adult patients who underwent first-time hemodialysis in a tertiary emergency department. Demographic, clinical, and laboratory variables were recorded at presentation and analyzed using univariate and multivariable logistic regression. Backward stepwise elimination was used to construct parsimonious models. The primary outcome was one-month all-cause mortality; the secondary outcome was the need for recurrent dialysis during the index admission or hospitalization. Results A total of 102 patients were included; median age was 66 years, and 61.8% (63) were male. One-month mortality was 30.4% (31), and 52.9% (54) required recurrent dialysis. In the multivariable model, age (OR: 1.100, 95% CI: 1.050–1.162, p < 0.001), lactate (OR: 1.250, 95% CI: 1.110–1.417, p < 0.001), and glucose (OR: 1.010, 95% CI: 1.001–1.014, p = 0.016) were independent predictors of one-month mortality. Creatinine was independently associated with recurrent dialysis (OR: 1.236; 95% CI: 1.068–1.432; p = 0.005), while lactate showed an inverse association (OR: 0.895; 95% CI: 0.811–0.988; p = 0.028). Conclusion One-month mortality and recurrent dialysis needs are high among patients receiving first-time emergency hemodialysis. Age, elevated lactate, and hyperglycemia independently predict mortality, while creatinine predicts recurrent dialysis requirement. Early identification of high-risk patients and timely correction of metabolic disturbances may improve outcomes.
Tuna et al. (2026) studied this question.