Survival Analysis and Its Determinants among Patients with End Stage Renal Disease in Eastern Ethiopia: A Retrospective Cohort Study

Abstract Background End-stage renal disease is the last stage of chronic kidney disease. It is estimated that by 2030 more than 70% of patients with end-stage renal disease would be living in low-income countries. The aim of this study was to analyze the survival time and its determinants among patients with end stage renal disease in Eastern, Ethiopia. Method A retrospective cohort study design was employed to analyze the survival time and its determinants among 754 end stage renal disease patients with hemodialysis follow up between September 1/2015 and August 30/2020 in Eastern Ethiopia. Data was collected from patients chart using listing questionnaire by 10 data collectors and analyzed using STATA version 14. Frequency tables and Kaplan-Meier graphs were used to describe the characteristic of the data, while the Weibull regression model was employed at 5% levels of significance to assess association between the covariates and the survival time of end stage renal disease patients. Result Among 754 hemodialysis patients, 176(23.3%) were died. The overall median survival time of patients in the five year follow up period was 40.695%CI: 38.54, 43.8 months, with a mortality rate of 5.84 95%CI: 5.04, 6.77 per 1000 person-months. In the Weibull regression model, urban area HR = 6.61, 95%CI: 2.67, 16.36, being widowed HR = 13.11, 95%CI:10.79, 16.09, having family history of RD HR = 1.42, 95%CI: 1.02, 2.97 and using central venous catheters vascular access HR = 2.52, 95%CI: 1.34, 4.34 were significantly associated with increased risk of death, while having follow up in Sheik Hassen hospital HR = 0.48, 95%CI: 0.26, 0.58, three times dialysis per week HR = 0.21, 95%CI: 0.09, 0.49, 4 dialysis hours per session HR = 0.26, 95%CI: 0.11, 0.63, and higher Kt/v level HR = 0.30, 95%CI: [0.11, 0.80 were significantly associated with lower risk of death. Conclusion The median survival time of patients was lower than other studies. AV fistula should be also adapted as dialysis modality.