Causes of Death in Patients Receiving Long-Term Hemodialysis

From August 1964 to June 1969, fifteen of 41 patients treated by long-term hemodialysis died. Four patients died of intracranial hemorrhage and two had convulsive disorders of unknown etiology which directly contributed to their death. Predialysis hypertension was present in four of these six patients. Five patients died with hyperkalemia and two patients died of infections. Other causes of death were suicide, congestive heart failure, and accidental death. The predominance of central nervous system symptoms in this group of patients suggests strongly that the development of neurologic disorders be considered an ominous sign in the patient receiving dialysis. More extensive dialysis, bilateral nephrectomy for intractable hypertension, and administration of potassium-binding resins will hopefully improve future results.