scholarly journals Modifiable Risk Factors for Early Mortality on Hemodialysis

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Rory McQuillan ◽  
Lilyanna Trpeski ◽  
Stanley Fenton ◽  
Charmaine E. Lok
Keyword(s):  
Risk Factors ◽  
Cox Model ◽  
Strong Predictor ◽  
Venous Catheter ◽  
Fold Increase ◽  
Hemodialysis Patients ◽  
Early Mortality ◽  
Modifiable Risk Factors ◽  
Risk Of Death ◽  
First 90 Days

Data of incident hemodialysis patients from 2001 to 2007 were abstracted from The Renal Disease Registry (TRDR) from central Ontario, Canada and followed until December 2008 to determine 90-day mortality rates for incident hemodialysis patients. Modifiable risk factors of early mortality were determined by a Cox model. In total, 876 of 4807 incident patients died during their first year on dialysis; 304 (34.7%) deaths occurred within the first 90 days of dialysis initiation. The majority of deaths were attributed to a cardiovascular event or infection and more likely occurred in older patients and those with cardiovascular co-morbidities. Of potentially modifiable risk factors, low body mass index (<18.5), a surrogate for malnutrition, was a strong predictor of early mortality [adjusted hazard ratio (HR) 4.22 (CI: 3.12–5.17)]. Also, central venous catheter use was associated with a 2.40 fold increase risk of death (CI: 1.4–3.90). Patients who attended a multidisciplinary pre-dialysis clinic were less likely to die (HR: 0.60, CI: 0.47–0.78). The first 90 days after initiation of dialysis is a period of especially high risk of death. We have identified potentially modifiable risk factors in vascular access type, pre-dialysis care and nutritional status.

MO412THE RISK FACTORS OF ACUTE KIDNEY INJURY CAUSED BY HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Siwen Wang ◽  
Jia Yang ◽  
Chen Xuelian ◽  
Jiaojiao Zhou ◽  
Lichuan Yang
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Strong Predictor ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Kidney Injury ◽  
Total Bilirubin Level ◽  
Risk Of Death

Abstract Background and Aims Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by overproduction of proinflammatory cytokines and hemophagocytosis. Acute kidney injury (AKI) is the most common complication of HLH in the kidney, which is a strong predictor of poor prognosis. In this retrospective study, we aimed to find the risk factors of AKI in patients with HLH. Method We screened all adult patients with HLH admitted to West China Hospital of Sichuan University from January 2009 to June 2019. Patients in this study were secondary HLH according to the HLH diagnostic criteria revised by the Histocyte Society in 2004. Patients with HLH were excluded from the study if they had a functioning kidney transplant, received renal replacement therapy (RRT) in the past month, suffered from end-stage renal disease (ESRD), or had the renal malignant tumor. We collected basic information, clinical manifestations, and laboratory data of patients from electronic medical records. Results A total of 600 patients with confirmed diagnosis of secondary HLH are included in our analysis. There are 199(33.2%)HLH-induced AKI patients, among whom 37.2%, 32.7%, and 30.2% are classified as AKI I, II, and III, respectively, according to the 2012 KDIGO (Kidney Disease: Improving Global Outcomes) guideline. Overall hospital mortality is 176(29.3%), and the number of deaths in patients with AKI was much higher than that in patients without AKI (53.3% versus 17.5%, P &lt; 0.001). The risk factors of AKI in patients with HLH were hyperphosphatemia (P&lt;0.001, OR 5.448, 95%CI 2.951-10.059) , vasopressor(P&lt;0.001, OR 3.485, 95%CI 2.114-5.746), heart failure (P=0.044, 0R 2.336, 95%CI 1.022-5.340), gastrointestinal symptoms (P=0.043, OR 1.877, 95%CI 1.021-3.453), increased heart rate (P=0.005, OR 1.017, 95%CI 1.005-1.029), elevated total bilirubin level(P&lt;0.001, OR 1.004, 95%CI 1.002-1.007), and hypoproteinemia (P=0.034, OR 0.939, 95%CI 0.886-0.995). Conclusion The incidence of AKI was higher in patients with HLH, and the risk of death was significantly higher in HLH patients with AKI. A variety of risk factors are related to the occurrence of HLH-induced AKI. Identifying and correcting them early in clinical diagnosis and treatment may reduce the incidence of AKI in patients with HLH and improve the prognosis of them.

scholarly journals Comparing the Clinical Characteristics and Mortality of Residential and Non-Residential Older People with COVID-19: Retrospective Observational Study

2022 ◽  
Vol 19 (1) ◽  
pp. 483
Author(s):  
Francesc X. Marin-Gomez ◽  
Jacobo Mendioroz-Peña ◽  
Miguel-Angel Mayer ◽  
Leonardo Méndez-Boo ◽  
Núria Mora ◽  
...  
Keyword(s):  
Risk Factors ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Fold Increase ◽  
The Elderly ◽  
Health Administration ◽  
Epidemic Outbreak ◽  
Risk Of Death ◽  
Using Data

Nursing homes have accounted for a significant part of SARS-CoV-2 mortality, causing great social alarm. Using data collected from electronic medical records of 1,319,839 institutionalised and non-institutionalised persons ≥ 65 years, the present study investigated the epidemiology and differential characteristics between these two population groups. Our results showed that the form of presentation of the epidemic outbreak, as well as some risk factors, are different among the elderly institutionalised population with respect to those who are not. In addition to a twenty-fold increase in the rate of adjusted mortality among institutionalised individuals, the peak incidence was delayed by approximately three weeks. Having dementia was shown to be a risk factor for death, and, unlike the non-institutionalised group, neither obesity nor age were shown to be significantly associated with the risk of death among the institutionalised. These differential characteristics should be able to guide the actions to be taken by the health administration in the event of a similar infectious situation among institutionalised elderly people.

scholarly journals P1529MORTALITY PREDICTORS IN INCIDENT HEMODIALYSIS PATIENTS - HAVE HEY CHANGED IN TEN YEARS?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Cátia Raquel Figueiredo ◽  
Rachele Escoli ◽  
Hernâni Gonçalves ◽  
Karina Lopes ◽  
Flora Sofia ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Demographic Data ◽  
Venous Catheter ◽  
Early Mortality ◽  
Risk Of Death ◽  
Cardiovascular Comorbidities ◽  
Causes Of Mortality ◽  
Mortality Predictors

Abstract Background and Aims In the last years there has been an increase in elderly patients with multiple comorbidities inducing hemodialysis (HD). Since dialysis treatment itself may be associated with a further deterioration in functional status, nephrologists are increasingly careful in selecting these patients for HD. Concerned with this reality we tried to understood if early mortality predictors (in the first 6 months) in incident HD patients have changed in almost 10 years, in the same hospital HD unit. Method This is a retrospective observational study of incident HD patients between 01 January 2017 and 30 June 2019. We evaluated similar clinical, analytical and demographic data to those used to predict mortality in the same HD unit from 1 January 2010 to 30 September 2014. Logistic regression analysis was used to evaluate 6 month mortality predictors. Statistical analysis was performed using SPSS version 25 for Windows. Results The average age of 163 incident HD patients were 70.63±3.9 years (similar to the previous population: n= 235; 70.7 ± 14.9 years) and 57.1% were male. During this study we observed 26 (16%) deaths, 12 of which (46.15%) occurred in the first 6 months of hemodialysis. Pneumonia and cachexia were the major causes of mortality, unlike the previous population, in which majority of deaths were attributed to cardiovascular events. Between January 2010 to 30 September 2014 the strongest predictors of early mortality were dementia [adjusted odds ratio (OR) 15.94 (CI: 4.09–62.10)], central venous catheter use [(OR) 12.29; (CI: 3.54-42.65)], cancer [(OR) 4.64 (CI: 1.48-14.54)] and heart failure [(OR) 3.57 (CI: 1.08-11.75)]. Differently, in this study, the institutionalization and the presence of metastases were the predictors that showed a higher risk of death [p=0.005; adjusted odds ratio [(OR) 10.4 (CI: 2.017–49.9) and p=0.01; (OR): 14.9 (CI: 1.89-42), respectively]. Longer hospitalizations at the time of HD induction [(p=0.044; (OR):1.103; CI: 1.003-1.213)] and albumin values &lt;2.5 mg/dL [(p=0.03; (OR): 3.8 (CI: 1.14-13)] were also strong mortality predictors. which were not previously observed. Conclusion Nowadays, nephrologists are less liberal in initiating dialysis to elderly patients with dementia and cardiovascular comorbidities. However, the population is getting older and our recent mortality predictors may reflect the aging of chronic kidney disease patients, who have multiple comorbidities as cachexia, requiring institutionalization and longer hospitalizations. It is increasingly important to evaluate patients prior to dialysis initiation, so our goal is to create an adjusted mortality score in our HD unit to help make the decision about inducing or not HD in our patients.

scholarly journals Sonographic and Clinical Features of Upper Extremity Deep Venous Thrombosis in Critical Care Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Michael Blaivas ◽  
Konstantinos Stefanidis ◽  
Serafim Nanas ◽  
John Poularas ◽  
Mitchell Wachtel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critical Care ◽  
Upper Extremity ◽  
Strong Predictor ◽  
Venous Catheter ◽  
Acute Thrombosis ◽  
Vein Thrombosis ◽  
Therapeutic Anticoagulation ◽  
Deep Vein ◽  
Critical Care Patients

Background-Aim. Upper extremity deep vein thrombosis (UEDVT) is an increasingly recognized problem in the critically ill. We sought to identify the prevalence of and risk factors for UEDVT, and to characterize sonographically detected thrombi in the critical care setting.Patients and Methods. Three hundred and twenty patients receiving a subclavian or internal jugular central venous catheter (CVC) were included. When an UEDVT was detected, therapeutic anticoagulation was started. Additionally, a standardized ultrasound scan was performed to detect the extent of the thrombus. Images were interpreted offline by two independent readers.Results. Thirty-six (11.25%) patients had UEDVT and a complete scan was performed. One (2.7%) of these patients died, and 2 had pulmonary embolism (5.5%). Risk factors associated with UEDVT were presence of CVC [(odds ratio (OR) 2.716,P=0.007)], malignancy (OR 1.483,P=0.036), total parenteral nutrition (OR 1.399,P=0.035), hypercoagulable state (OR 1.284,P=0.045), and obesity (OR 1.191,P=0.049). Eight thrombi were chronic, and 28 were acute. We describe a new sonographic sign which characterized acute thrombosis: a double hyperechoic line at the interface between the thrombus and the venous wall; but its clinical significance remains to be defined.Conclusion. Presence of CVC was a strong predictor for the development of UEDVT in a cohort of critical care patients; however, the rate of subsequent PE and related mortality was low.

scholarly journals Prognostic value of Ki-67 in patients with hypertension and prostate cancer: A real-world study in a Chinese population

2020 ◽  
Author(s):  
Zhijun Cao ◽  
Mengqi Xiang ◽  
Zhiyu Zhang ◽  
Jianglei Zhang ◽  
Minjun Jiang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prognostic Value ◽  
Cox Regression ◽  
Cox Model ◽  
Prognostic Nutritional Index ◽  
Fold Increase ◽  
Lasso Regression ◽  
Ki 67 ◽  
Risk Of Death ◽  
Risk Of Progression

Abstract Background Prostate cancer is the second most common malignancy in males worldwide, with high mortality, especially when combined with hypertension. Ki-67 is one of the most reliable markers of growth for neoplastic human cell populations. However, the prognostic value of Ki-67 in patients with hypertension and prostate cancer remains unclear.Methods We retrospectively analyzed 296 patients with hypertension and prostate cancer from May 1, 2012, to October 1, 2015. The overall survival was evaluated by Cox regression models and Kaplan-Meier analysis. In addition, a nomogram was established, and the accuracy of the model was assessed by a calibration curve.Results A total of 101 (34.1%) patients died. In the multivariate analysis, being Ki-67(+) was associated with a >5-fold increase in the risk of death (hazard ratio [HR] 5.83, 95% confidence interval [CI] 3.35-10.14, p<0.001) and a 2-fold increase in the risk of progression (HR 2.06, 95% CI 1.37-3.10, p<0.001). Multivariate Lasso regression showed that smoking, heart failure, ACS, Ki-67 expression, serum albumin, prognostic nutritional index, surgery, Gealson score, and stage were positively associated with prognosis in patients with prostate cancer. To quantify the contribution of each covariate to the prognosis, a nomogram of the Cox model was generated. The nomogram demonstrated excellent accuracy in estimating the risk of death, with a bootstrap-corrected C index of 0.829. There was also a suitable calibration curve for risk estimation.Conclusions The presence of Ki-67 predicts worsened outcomes for overall mortality. A cross-validated multivariate score including Ki-67 had excellent concordance and efficacy for predicting prostate cancer.

scholarly journals Vascular Access, Complications and Survival in Incident Hemodialysis Patients

2021 ◽  
Vol 1 (2) ◽  
pp. 88-99
Author(s):  
Massimo Torreggiani ◽  
Lucia Bernasconi ◽  
Marco Colucci ◽  
Simone Accarino ◽  
Ettore Pasquinucci ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Central Venous Catheter ◽  
Vascular Access ◽  
Hospital Admissions ◽  
Patient Survival ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Central Venous ◽  
Risk Of Death ◽  
Access Complications

The arteriovenous fistula (AVF) has long been considered the optimal vascular access. However, the evolving characteristics of the ageing dialysis population limit the creation of an AVF in all patients. Thus, more patients start hemodialysis (HD) with a central venous catheter (CVC) rather than an AVF, and the supremacy of the AVF has recently been questioned. The aim of this study was to analyze the incidence and rate of access complications in 100 patients between 2010 and 2015. A total of 63 patients started HD with an AVF, while 37 began HD with a CVC. We found no differences in patient survival according to the vascular access in use at the beginning of dialysis, but patients were more likely to die while undergoing dialysis by means of a CVC than an AVF. Patients started on dialysis with a CVC had more cardiovascular disease, while patients who began dialysis with an AVF presented more hypertension. Fistulas presented a longer survival time despite more hospital admissions, but CVCs bore a higher risk of infections. Our results suggest that starting dialysis with a CVC does not confer a greater risk of death.

Abstract 16187: Incidence, Risk Factors, and Outcomes of Atrial Fibrillation After Blood and/or Marrow Transplant

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daniel Pinkhas ◽  
John Ning ◽  
Hyun Kim ◽  
Matthew Subramani ◽  
Anita D'Souza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Early Period ◽  
Marrow Transplant ◽  
Early Mortality ◽  
Incidence Risk ◽  
History Of ◽  
First 90 Days

Introduction: Atrial fibrillation (AF) is known to occur after blood and/or marrow transplant (BMT) and has been shown to increase morbidity and mortality. Our objective was to characterize the incidence, risk factors, and clinical impact of AF in patients within the first 90 days after BMT. Methods: Patients with active malignancy undergoing BMT from 2012-2016 at the Medical College of Wisconsin were included (n=1159). Medical records were reviewed for baseline patient characteristics, AF risk factors, and clinical outcomes. Patients were categorized based on development of AF within 90 days post-BMT. Baseline characteristics and risk factors were analyzed to determine predictors for AF and all-cause mortality at 90 days. Results: Amongst the entire cohort, 5.3% of patients developed AF within the first 90 days after BMT. Significant baseline differences between those with or without AF post-BMT are outlined in Table 1. Multivariable analysis showed that a history of AF (OR: 6.7; 95% CI: 3.3-13.6; P = <0.001) and prior XRT (OR: 2.3; 95% CI: 1.2-4.6; P = 0.018) were independent predictors of developing AF. Univariate analysis demonstrated that AF was associated with 90-day mortality (HR: 7.6; 95% CI: 3.5-16.5; log rank P < 0.001). Multivariable analysis (adjusted for age, gender, race, history of XRT, BMT type, and malignancy type) revealed that female gender (HR: 2.6; 95% CI: 1.2-5.5; P = 0.016), non-Caucasian race (HR: 2.7; 95% CI: 1.1-6.4; P = 0.024) and development of AF (HR: 9.2; 95% CI: 3.7-21.5; P < 0.001) were significant independent predictors of early mortality. Conclusions: This analysis demonstrated that a prior history of AF and prior XRT were independent predictors for the development of AF in the early period post-BMT and AF is a significant independent predictor of early mortality after BMT. Further studies assessing the potential benefits of AF prevention in patients after BMT is warranted.

Abstract 2386: Growth-Differentiation Factor-15 is a Strong Predictor of Adverse Outcomes in Heart Failure: Results from Val-HeFT.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Inder S Anand ◽  
Tibor Kempf ◽  
Heike Tapken ◽  
Tim Allhoff ◽  
Michael Kuskowski ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cox Model ◽  
Strong Predictor ◽  
Nyha Class ◽  
Adverse Outcomes ◽  
Prognostic Information ◽  
Significant Independent Predictor ◽  
Growth Differentiation Factor 15 ◽  
Risk Of Death ◽  
Differentiation Factor

Background: Growth-Differentiation Factor-15 (GDF-15) is a member of the TGF-β family that is induced in the heart after myocardial injury. In patients with non-ST segment elevation ACS, GDF-15 is increased and provides prognostic information. Its role in heart failure is unknown. Methods & Results: GDF-15 was measured in 1125 Val-HeFT patients at baseline. Baseline median GDF-15 was 2027 ng/L (IQ range 1447 to 2942) and was abnormal (>1200 ng/L) in 86% of patients. Patients with GDF-15 above the median had higher NYHA class, greater volume load, lower LVEF and eGFR, higher hsCRP, norepinephrine, BNP and aldosterone, lower use of beta-blockers and higher use of diuretics (all p<0.01). In a multivariate COX model including all baseline variables, GDF-15 was a significant independent predictor of death (HR, 1.5, 95% CI, 1.06–2.14), first morbid event (HR 1.56, 95% CI, 1.19–2.04), and hospitalizations for HF (HR, 1.93, 95% CI, 1.33–2.80), as was BNP for all the three endpoints (HR, 1.7, 95% CI, 1.27–2.3), (HR 1.84, 95% CI, 1.45–2.35), and (HR, 1.98, 95% CI, 1.43–2.7). Spearman correlation of BNP with GDF-15 was 0.33 p<0.001. To test whether GDF-15 adds prognostic information over that provided by BNP, patients were sub-grouped using the median BNP (96 pg/mL) and GDF-15 (2027 ng/L). Figure shows survival curves for the four subgroups. In a multivariate COX analysis when both GDF-15 and BNP were above the median, the risk of death was nearly three times as great (HR 2.75, 95% CI 1.75–4.30, p<0.001) compared to those with both below the median. Conclusion: GDF-15 is an important prognostic marker in HF, independent of other markers and adds prognostic information to that provided by BNP alone.

scholarly journals Risk Factors for Mortality in Hemodialysis Patients: Two-Year Follow-Up Study

2013 ◽  
Vol 35 ◽  
pp. 791-798 ◽  
Author(s):  
Maria do Sameiro-Faria ◽  
Sandra Ribeiro ◽  
Elísio Costa ◽  
Denisa Mendonça ◽  
Laetitia Teixeira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Iron Metabolism ◽  
Venous Catheter ◽  
Large Set ◽  
Dialysis Adequacy ◽  
Risk Of Death ◽  
Follow Up Study ◽  
Stage Renal Disease ◽  
Fourth Quartile

Background.End-stage renal disease (ESRD) patients under hemodialysis (HD) have high mortality rate. Inflammation, dyslipidemia, disturbances in erythropoiesis, iron metabolism, endothelial function, and nutritional status have been reported in these patients. Our aim was to identify any significant association of death with these disturbances, by performing a two-year follow-up study.Methods and Results.A large set of data was obtained from 189 HD patients (55.0% male; 66.4 ± 13.9 years old), including hematological data, lipid profile, iron metabolism, nutritional, inflammatory, and endothelial (dys)function markers, and dialysis adequacy.Results.35 patients (18.5%) died along the follow-up period. Our data showed that the type of vascular access, C-reactive protein (CRP), and triglycerides (TG) are significant predictors of death. The risk of death was higher in patients using central venous catheter (CVC) (Hazard ratio [HR] =3.03, 95% CI = 1.49–6.13), with higher CRP levels (fourth quartile), compared with those with lower levels (first quartile) (HR = 17.3, 95% CI = 2.40–124.9). Patients with higher TG levels (fourth quartile) presented a lower risk of death, compared with those with the lower TG levels (first quartile) (HR = 0.18, 95% CI = 0.05–0.58).Conclusions.The use of CVC, high CRP, and low TG values seem to be independent risk factors for mortality in HD patients.

scholarly journals Risk Factors for Low Humoral Response to BNT-162b2 In Hemodialysis Patients

2021 ◽  
Author(s):  
Rui Duarte ◽  
Cátia Figueiredo ◽  
Ivan Luz ◽  
Francisco Ferrer ◽  
Hernâni Gonçalves ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Humoral Response ◽  
Venous Catheter ◽  
Hemodialysis Patients ◽  
Older Age ◽  
Maintenance Hemodialysis ◽  
List Type ◽  
Central Venous ◽  
Dialysis Vintage

AbstractIntroductionMaintenance Hemodialysis (HD) patients are at higher risk of both infection and mortality associated with the new coronavirus 2. Immunization through large-scale vaccination is the cornerstone of infection prevention in this population. This study aims to identify risk factors for low response to the BNT-162b2 (Pfizer BioNTech) vaccine in a HD cohort.Materials and MethodsObservational prospective study of a HD group followed in a Portuguese Public Founded Hemodialysis Center who received BNT-162b2 vaccination. Specific anti-Spike IgG was evaluated as arbitrary units per milliliter (AU/mL) on two separate occasions: 3 weeks after the first dose and 3 weeks after the second. IgG titers, Non-Responders (NR), and Weak-Responders (WR) after each dose were evaluated against risk factors that included demographic, clinical and analytical variables.ResultsHumoral response evaluated by IgG anti-Spike levels showed a strong correlation with Charlson comorbidity index (CCI) and intact parathormone (iPTH) after each inoculation (1st dose: ρ=−0.64/0.54; 2nd dose: ρ=−0.66/0.63, respectively; p<0.01 throughout). After completing both doses: 1) NR were associated with female sex (p<0.01), lower albumin and iPTH (p=0.01); 2) WR showed higher CCI, older age, lower iPTH and lower albumin (p=<0.01, p=0.03, p<0.01, p=0.05, respectively) and, consistently, associated with CCI over 8, age over 75, iPTH under 150 ng/L, female sex, dialysis vintage under 24 months and central venous catheter (CVC) over arteriovenous fistula (p=0.01, p=0.03, p<0.01, p=0.01, p=0.01, p<0.01, respectively). A binary regression model using CCI, sex (male) and CVC was statistically significant in prediction of WR after the 2nd dose with OR (95% CI): 1.81 (1.06-3.08); 0.05 (0.01-0.65); 13.55 (1.06-174.18), respectively (p=0.01).ConclusionOlder age, higher CCI, lower iPTH and albumin, CVC as vascular access and recent hemodialysis initiation (less than 2 years) associate with lower response to vaccination in our study. A higher comorbidity burden is suggested as a more significant surrogate marker for low immunogenicity rather than age alone. Identifying HD patients as a population at high-risk for low response to vaccination is essential for proper policy-making, facilitating the implementation of adequate and individualized contingency protocols.What is already known about this subjectMaintenance hemodialysis patients have lower humoral response to BNT-162b2 COVID-19 vaccine when compared to the general population.Maintenance dialysis patients are at high risk of exposure to coronavirus 2 in addition to a more severe disease course.What this study addsWe suggest Charlson commorbidity index, older age, intact parathormone, central venous catheter as vascular access and lower dialysis vintage as possible surrogate markers of immunogenicity in HD patients.There is a low humoral response after a single dose of the vaccine (50%) that can be increased after the second (86%).What impact this may have on practice or policyStrict Protocols for follow-up measures in HD patients, including closer humoral titers assessment, risk stratification, adequate isolation, and surveillance of symptoms might be necessary in order to improve this population survival/life expectancy.Screening HD patients, seroconversion rates may be improved by giving extra inoculations for patients at risk for low response.

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