Maintenance Hemodialysis: Survival Beyond the First Decade

In a retrospective analysis of maintenance dialysis (MD) in a relatively homogeneous population of 24 patients (18 men, six women) who first received MD between 1964 and 1968 and who were initially free of other complicating diseases, we have confirmed that age at initiation of dialysis, sustained hypertension, and elevated calcium-phosphate product are significant risk factors for cardiovascular mortality. In patients without these risk factors sepsis has become the major cause of death, accounting for five (35.7%) of 14 deaths. The limit for long-term survival in an MD patient in whom the well-recognized risk factors are prevented or controlled is not yet apparent.