Epidemiology and multimorbidity in hemodialysis patients at a tertiary care center in northern Mexico: implications for hospital-based adverse outcomes

Introduction: Patients with chronic kidney disease (CKD) in maintenance hemodialysis are vulnerable to adverse hospital-based outcomes. The present study aimed to describe the association between clinical variables and hospital admission and mortality in patients ascribed to an outpatient hemodialysis unit in northeastern Mexico. Methods: We conducted a retrospective analytical study with data recorded during the period of January to June 2025. 215 adult patients with maintenance hemodialysis were included. Associations between clinical data and hospitalizations, readmissions, and in-hospital mortality were analyzed. Results: In the present study, 32.8% of patients had CKD related to diabetes mellitus and hypertension. 53% of patients received two hemodialysis sessions per week. The median number of comorbidities was two and hypertension was the most frequent comorbidity. 37% of patients required at least one hospital admission; the most common cause of hospitalization was volume overload followed by infections. 12% of hospitalized patients died. Hospital admission was associated with cancer, erythropoietin use, fewer hemodialysis sessions and uncontrolled hypertension. Mortality was associated with peripheral artery disease, erythropoietin use and male gender. In multivariable analyses, no independent predictors of in-hospital mortality were identified. We observed a tendency towards an association between diuretic use and hospital readmissions. Conclusion: Comorbidity burden, pharmacologic treatment and hemodialysis prescription should be taken into account in patients with maintenance hemodialysis to lower hospital-based adverse outcomes. Diagnostic and therapeutic strategies aimed at diminishing volume overload may have a significant impact reducing hospitalizations in outpatient hemodialysis patients.