Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 29 (4), 235-241

Risk Factors for 3-Year-Mortality and a Tool to Screen Patient in Dialysis Population


Risk Factors for 3-Year-Mortality and a Tool to Screen Patient in Dialysis Population

M A Bujang et al. Indian J Nephrol.


Introduction: Clinical parameters especially co-morbidities among end stage renal disease (ESRD) patients are associated with mortality. This study aims to determine the risk factors that are associated with mortality within three years among prevalent patients with ESRD.

Methods: This is a cohort study where prevalent ESRD patients' details were recorded between May 2012 and October 2012. Their records were matched with national death record at the end of year 2015 to identify the deceased patients within three years. Four models were formulated with two models were based on logistic regression models but with different number of predictors and two models were developed based on risk scoring technique. The preferred models were validated by using sensitivity and specificity analysis.

Results: A total of 1332 patients were included in the study. Majority succumbed due to cardiovascular disease (48.3%) and sepsis (41.3%). The identified risk factors were mode of dialysis (P < 0.001), diabetes mellitus (P < 0.001), chronic heart disease (P < 0.001) and leg amputation (P = 0.016). The accuracy of four models was almost similar with AUC between 0.680 and 0.711. The predictive models from logistic regression model and risk scoring model were selected as the preferred models based on both accuracy and simplicity. Besides the mode of dialysis, diabetes mellitus and its complications are the important predictors for early mortality among prevalent ESRD patients.

Conclusions: The models either based on logistic regression or risk scoring model can be used to screen high risk prevalent ESRD patients.

Keywords: End stage renal disease; mortality; risk factors; screening tool; sensitivity and specificity.

Conflict of interest statement

There are no conflicts of interest.

Similar articles

See all similar articles


    1. Szczech LA, Lazar IL. Projecting the United States ESRD population: Issues regarding treatment of patients with ESRD. Kidney Int Suppl. 2004;66:S3–7. - PubMed
    1. The National Renal Registry. 22nd Report of the Malaysian Dialysis and Transplant Registry 2014. Kuala Lumpur, Malaysian Society of Nephrology. 2015
    1. Bujang MA, Adnan TH, Hashim NH, Mohan K, Kim Liong A, Ahmad G, et al. Forecasting the incidence and prevalence of patients with end-stage renal disease in Malaysia up to the year 2040. Int J Nephrol. 2017;2017:2735296. - PMC - PubMed
    1. Held PJ, Brunner F, Odaka M, García JR, Port FK, Gaylin DS, et al. Five-year survival for end-stage renal disease patients in the United States, Europe, and Japan, 1982 to 1987. Am J Kidney Dis. 1990;15:451–7. - PubMed
    1. Bujang MA, Musa R, Liu WJ, Chew TF, Lim CT, Morad Z, et al. Depression, anxiety and stress among patients with dialysis and the association with quality of life. Asian J Psychiatr. 2015;18:49–52. - PubMed