Factors associated with mortality and hospitalizations in Nipro units in Brazil, Ecuador, and Chile (BENCH Study).

Abstract

Introduction: Morbidity and mortality in hemodialysis (HD) serve as the best indicators of the quality of the hemodialysis process. Identifying associated factors is a fundamental aspect of nephrological care—particularly when dealing with a large patient population—as it enables the development of decision-making strategies. This study aims to identify factors associated with mortality and hospitalizations among HD patients.

Materials and Methods: This was a descriptive, cross-sectional, multicenter (international) observational study. The study population consisted of HD patients treated at Nipro units in Brazil, Ecuador, and Chile between January and June 2025 (3,943 patients). Data were analyzed using the IBM SPSS 25.0 statistical package. Analyses included frequency distribution; factors related to mortality and hospitalizations were identified using tests of independence, one-way analysis of variance (ANOVA), or t-tests, depending on the nature of the analysis.

Results: Advanced patient age; obstructive causes and Diabetes Mellitus as the underlying causes of chronic kidney disease (CKD); vascular access other than an arteriovenous fistula (AVF); low levels of hemoglobin, albumin, and PTH; elevated CRP; and lower Kt/V values ​​and high EPO doses were all found to be associated with mortality (Table 1) and hospitalizations (Table 2) (p<0.05).

Conclusions: Intervention strategies aimed at reducing morbidity and mortality in HD patients should specifically target older patients; those with urinary obstruction and Diabetes Mellitus as causes of CKD; those using vascular access other than AVF; those with low hemoglobin, albumin, and PTH levels; and, above all, those with high CRP levels, low dialysis doses, and a need for high EPO doses.