Exploring Mortality and Associated Risks Among Assisted Home Hemodialysis Patients in Qatar

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Exploring Mortality and Associated Risks Among Assisted Home Hemodialysis Patients in Qatar

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Co-author 1

Abdullah Hamad AHamad9@hamad.qa Hamad Medical Corporation Medicine Doha Qatar *

Co-author 2

Mossab Filali v-mfilali@hamad.qa Hamad Medical Corporation Medicine Doha Qatar -

Co-author 3

FADWA ALALI FALALI1@hamad.qa Hamad Medical Corporation Medicine Doha Qatar -

Co-author 4

Mostafa Elshirbeny MElshirbeny@hamad.qa Hamad Medical Corporation Medicine Doha Qatar -

Co-author 5

Mohamed Yahya MMohamed24@hamad.qa Hamad Medical Corporation Medicine Doha Qatar -

Co-author 6

Moahamad Alkadi malkadi@hamad.qa Hamad Medical Corporation Medicine Doha Qatar -

Co-author 7

Rania Ibrahim RIbrahim4@hamad.qa Hamad Medical Corporation Medicine Doha Qatar -

Co-author 8

Ahamad Abdelwahed a.adel@metcocare.com Hamad Medical Corporation Medicine Doha Qatar -

Co-author 9

Hoda Tolba HTOLBA@hamad.qa Hamad Medical Corporation Medicine Doha Qatar -

Co-author 10

FADUMO YASIN FYASIN@hamad.qa Hamad Medical Corporation Medicine Doha Qatar -

Co-author 11

Sandhya Chembolu s.chembolu@metcocare.com Hamad Medical Corporation Medicine Doha Qatar -

Co-author 12

Hasan Almalki halmalki1@hamad.qa Hamad Medical Corporation Medicine Doha Qatar -

Co-author 13

Co-author 14

Co-author 15

Introduction

Home hemodialysis is a well-established modality that promotes patient independence but poses significant challenges, particularly in regions like the Gulf Cooperation Council (GCC) countries. Assisted HHD (AHHD) has gained momentum in the GCC over the past few years. Qatar’s AHHD program has expanded substantially in the past two years. This study examines the demographics, mortality rates, and associated risk factors within Qatar’s AHHD patient population.

Methods

This was a retrospective observational national data review for all AHHD patients in Qatar between July 2021 and December 2023. Patients had to be > 60 years old and have limited mobility to be eligible for the AHHD program and included in the study. This study was supported by the Institutional Review Board of The Medical Research Center at Hamad Medical Corporation (MRC-01-24-014).

Results

We had 114 AHHD patients with a median age of 71.5; 54 (47.4%) were males. During the study period, 20 patients (17.5 %) died, and 8 (7%) stopped receiving the service for traveling abroad, personal preference for in-center HD, or changing dialysis modality. Most deaths occurred due to infectious causes. The deceased patients had significantly less HD vintage, more severe immobility, and more hospitalizations compared to the alive participants. On multivariate analysis, patients with severe immobility had 3.8 (CI: 1.1-12.8, 95% p=0.031) higher odds of mortality than patients with mild to moderate immobility.

Conclusion

Our study found that mortality in the AHHD program is significant and mostly related to mobility status. Patients with severely reduced mobility had almost 4 times the risk of mortality compared to more mobile patients. Further larger studies are needed to confirm these findings.

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