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

Abstract

Background

Home hemodialysis (HD) is a well-established modality that promotes patient independence but poses significant challenges, particularly in regions like the Gulf Cooperation Council (GCC) countries. Assisted home HD has gained momentum in the GCC over the past few years. Qatar's assisted home HD program has expanded substantially in the past 2 years. This study examines the demographics, mortality rates, and associated risk factors within Qatar's assisted home HD patient population.

Methods

This was a retrospective cohort study to review national data for all assisted home HD 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 assisted home HD program and included in the study.

Results

We had 114 assisted home HD 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 < 0.05) times higher odds of mortality than patients with mild to moderate immobility.

Conclusion

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