Abstract:Objective To retrospectively analyze the characteristics of maintenance hemodialysis (MHD) patients who have died in the past decade, with the aim of understanding the mortality rate, causes of death, and other factors in MHD patients. Methods A total of 110 MHD patients who died from January 2014 to December 2023 at the Hemodialysis Center of the Second Affiliated Hospital of Anhui Medical University, with a dialysis duration of more than 3 months, were selected. Demographic and clinical data were collected, including the annual mortality rates. The patients were divided into three age groups at the time of death the middle-aged and young group (<60 years) with 26 cases, the elderly group (60-79 years) with 61 cases, and the advanced-aged group (≥80 years) with 23 cases. Demographic characteristics, causes of death, dialysis vintage, and other factors were analyzed for each group. The age of death and dialysis duration among patients with different primary diseases were also compared. Results Among the 110 deceased patients, 70 were male and 40 were female, and their ages were 35-91 (68.76 ± 12.24) years old. The annual mortality rates for MHD patients from 2014 to 2023 were 5.36%, 6.67%, 5.83%, 7.50%, 6.06%, 5.56%, 4.08%, 5.45%, 9.45%, 8.87%, respectively. The primary causes of death were cardiovascular events (myocardial infarction, heart failure, 31.82%), cerebrovascular events (cerebral hemorrhage, cerebral infarction, 20.00%), infections (20.00%), malignancies (10.00%), and gastrointestinal bleeding (9.09%). The middle-aged and young group had the highest number of deaths due to cerebral hemorrhage (30.77%), myocardial infarction (15.38%), and sudden death (15.38%); the elderly group had the highest number due to myocardial infarction (24.59%), infections (21.31%), and malignancies (14.75%); the advanced-aged group primarily had deaths due to heart failure (26.09%), cerebral infarction (21.74%), and infections (21.74%). The dialysis vintage for the middle-aged and young group was 71.00 (26.75, 128.50) months, for the elderly group was 60.00 (36.00, 96.00) months, and for the advanced-aged group was 36.00 (24.00, 50.00) months, with a statistically significant difference between the groups (Z= 9.039, P= 0.011). Among all the deceased patients, those with diabetic kidney disease accounted for the highest proportion at 40.00% (44/110). There was a statistically significant difference in the age of death among different primary disease groups (P＜0.05). But there was no significant difference in dialysis vintage among patients with different primary diseases ( P> 0.05). Conclusion In the Hemodialysis Center of the Second Affiliated Hospital of Anhui Medical University, MHD patients who died were mostly elderly. The primary causes of death were cardiovascular and cerebrovascular events, infections, and malignancies. The causes of death varied by age group. In addition to cardiovascular events, sudden death in younger patients and infections and malignancies in older patients need to be given special attention. Moreover, advanced age and diabetes may also be important factors affecting the prognosis of MHD patients.