title: Level of dependence in patients on haemodialysis in Catalonia and evolution of mortality rates.
abstract: BACKGROUND
  Age and the comorbidities associated with ESRD impair the functional autonomy of patients on haemodialysis (HD). Our objectives were to assess the level of dependence in patients on HD and their mortality rates after three years of treatment. To do so, we followed the criteria established by the "Ley de Promoción de la Autonomía Personal y Atención a las Personas en situación de dependencia", the Spanish Law of Dependence (LD).
  
  
  METHODS
  We carried out a cross-sectional descriptive study between October 2007 and January 2008. From 3702 patients in 40 dialysis units in Catalonia, 806 were selected as potential dependent individuals according to the criteria of their healthcare providers. Variables studied included: level of dependence according to the LD criteria, age, time on HD, associated pathology, treatment characteristics, family circumstances, and survival from 2009 to 2011.
  
  
  RESULTS
  According to the LD, 137 were not dependent, 350 had a grade 1 dependence level, 237 grade 2, and 82 grade 3. In addition, 121 were living in an institution. The mean age was 74.9 ± 18.2 years and the median time on HD was 36 months. The prevalence of common pathologies was: diabetes (35.7%) and cardiovascular disease (29.1%). Musculoskeletal alterations (87%) and neurological disorders (38%) were the main causes of dependence. 64.2% of patients had a catheter as a vascular access. 34.9% of patients survived after three years, and these had a lower level of dependence when compared to those patients who had died, with no statistically significant differences within those three years.
  
  
  CONCLUSIONS
  According to the LD, the prevalence of dependent patients in Catalonia is substantial (18.07%). These patients have a high mortality rate after three years.
authors.affiliation: Departamento de Enfermería Medicoquirúrgica, Escuela de Enfermería de la Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain. lolaandreu@ub.edu
authors.forename: Lola
authors.initials: L
authors.lastname: Andreu-Periz
authors.forename: Montserrat
authors.initials: M
authors.lastname: Puig-Llobet
authors.forename: Aleix
authors.initials: A
authors.lastname: Cases-Amenós
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis / Q000401:mortality*