Influence of Infections on the 36-Week Survival of Chronic Hemodialysis Patients at the Hemodialysis Unit of the General Hospital of Douala, Cameroon

Abstract

Background: The absence of local data on the survival of hemodialysis patients complicates the optimization of their care in Cameroon, a country characterized by a high prevalence of chronic kidney disease (CKD). This study, conducted at the hemodialysis unit of the General Hospital of Douala (GHGD), aimed to address this gap by assessing the 36-week survival of hemodialysis patients with CKD, thus providing essential data to enhance clinical practices and inform public health decisions. Methods: We conducted a prospective study at GHGD over a period of 9 months, monitoring 262 hemodialysis patients. Sociodemographic data, comorbidities, the presence of infections, adherence to regular hemodialysis sessions, and the week of death were collected using a structured survey form. The Kaplan-Meier estimator and Cox regression model were used to analyze patient survival. Results: The mean age of the patients was 49 ± 14 years. Adherence to hemodialysis sessions (HR = 0.19, p < 0.001) was associated with improved survival, while the presence of infections at the vascular access site (HR = 2.23, p = 0.05) and diabetes (HR = 3.31, p = 0.005) increased the risk of mortality. The probability of survival was significantly lower for patients with catheter infections (p < 0.001), particularly when the infecting agent was Burkholderia cepacia (p = 0.006), and for those who were divorced (p = 0.001). Conclusion: Strengthening infection prevention and providing psychosocial support for patients with CKD are crucial measures to improve patient care and develop public health strategies tailored to local needs.