title: Morbidity and mortality on chronic haemodialysis: a 10-year Swiss single centre analysis.
abstract: BACKGROUND
  Patient survival on chronic haemodialysis varies considerably among different countries and healthcare systems. To date, the survival of Swiss dialysis patients has not been analysed separately.
  
  
  METHODS
  We consecutively enrolled 266 patients entering the chronic haemodialysis program of the University Hospital Basel between 01.01.1995 and 30.06.2006 into a cohort study. Patient survival on chronic haemodialysis was the primary endpoint. Pre-specified sub-group analyses were performed for female and diabetic patients.
  
  
  RESULTS
  Patient age ranged from 15 to 90 years. Seventy-two percent suffered either from coronary artery, peripheral artery or cerebrovascular disease and 34% from diabetes. Sixty-nine (26%) patients underwent kidney transplantation. Transplanted patients were significantly younger (p <0.01) and less likely to suffer from diabetes (p <0.01) and atherosclerotic diseases (coronary, peripheral, cerebrovascular p for all ≤0.01). Median survival was 4.25 years (95%CI 3.66-5.50), with one, three and five year survival rates reaching 88%, 68% and 46%. Survival rates were equal in men and women (p = 0.34), among diabetic and non-diabetic patients (p = 0.41) and among men and women stratified for the presence of diabetes (p = 0.13). Overall, 34% (91/266) patients died during the observational period. Thirty three percent of all deaths were caused by cardiac events, followed by malignant diseases (8%) and infections (7%). In 9% (23/266) dialysis was withdrawn and withdrawal of dialysis contributed to death in 25% (23/91).
  
  
  CONCLUSIONS
  Survival on chronic haemodialysis treatment in Switzerland compares favourably to international reference values. Dialysis withdrawal and the frequency of kidney transplantation impact long term patient outcome and should be adjusted for when comparing mortality analysis.
authors.affiliation: Medical Outpatient Department, Petersgraben 4, CH-4031 Basel. tbreidthardt@uhbs.ch
authors.forename: Tobias
authors.initials: T
authors.lastname: Breidthardt
authors.forename: Cora Nina
authors.initials: CN
authors.lastname: Moser-Bucher
authors.forename: Claudia
authors.initials: C
authors.lastname: Praehauser
authors.forename: Daniela
authors.initials: D
authors.lastname: Garzoni
authors.forename: Katrin
authors.initials: K
authors.lastname: Bächler
authors.forename: Juerg
authors.initials: J
authors.lastname: Steiger
authors.forename: Michael
authors.initials: M
authors.lastname: Dickenmann
authors.forename: Michael
authors.initials: M
authors.lastname: Mayr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D016019:Survival Analysis; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult