Multicenter cohort study reveals a 58.2% five-year survival rate among maintenance hemodialysis patients, highlighting session frequency and age as key determinants of long-term outcomes.
Key Points
To evaluate long-term survival outcomes and determine prognostic factors affecting mortality in patients undergoing maintenance hemodialysis.
Multicenter cohort study of 24,775 patients receiving maintenance hemodialysis for >90 days between August 2008 and April 2025 across 288 centers in 16 states in India.
Hemodialysis vintage was calculated from Day 0, excluding patients who died or exited prior to Day 90.
Evaluated overall patient survival as the primary outcome using multivariable Cox proportional hazards modeling to assess demographic and treatment-related predictors.
Overall patient survival was 87.7% (95% CI, 87%–88%) at 1 year and 58.2% (95% CI, 57%–59%) at 5 years.
Five-year survival decreased significantly with age (<45 years: 73% [95% CI, 72%–75%]; 45–65 years: 61% [95% CI, 59%–62%]; >65 years: 45% [95% CI, 42%–49%]; p < 0.001) and was lower in diabetic patients (65% [95% CI, 62%–67%] vs 74% [95% CI, 73%–75%], p < 0.001).
Multivariable Cox proportional hazards modeling showed a 15% higher mortality for females (p < 0.001), while 5-year survival reached 81% for >3 weekly sessions compared to 65% for <2 weekly sessions.