To retrospectively analyze data of death in hemodialysis (HD) patients of Shanxi Province from 2016 to 2019, so that support can be provided for improving the quality of HD.

Through the Chinese National Renal Data System (CNRDS), data were collected from the HD patients directly reported online by all medical institutions that carry out blood purification treatment in Shanxi Province from 2016 to 2019. The patients were divided into elderly group (≥60 years old) and young- middle-aged group (<60 years old). Analyses were made for age at death, dialysis age, annual mortality rate, primary disease, and cause of death, etc.

The annual mortality rate of HD patients in Shanxi Province from 2016 to 2019 ranged from 5.3% to 6.1%. The age range of dialysis was 0-290 months, with a median dialysis age of 31 months. The mortality rate of patients who had started dialysis for less than 1 year accounted for 18.6%. The mortality rate peaked in patients who had started dialysis for 5 to 10 years. The annual mortality rate was highest in diabetic nephropathy (9.5%), followed by hypertensive renal damage (5.4%) and primary glomerular diseases (3.6%). In the elderly group, the mortality rate was highest in diabetic nephropathy (34.2%), while in the young-middle-aged group, the mortality rate was highest in primary glomerular diseases (29.6%). The first cause of death was cardiovascular events (38.4%), followed by cerebrovascular events (25.1%), infection (7.2%), and digestive tract bleeding (4.3%). The first cause of death was cardiovascular events in the elderly group (30.3%), but was cerebrovascular events in the young-middle-aged group (26.0%).

The annual mortality rate of HD patients in Shanxi Province was on the decline, and the average dialysis age of the dead patients was prolonged. HD patients with diabetic nephropathy had the highest annual mortality rate, who were mostly elderly patients. Although the mortality rate of cardiovascular events was on the decline, it was still the first cause of death in the HD patients, and also in the elderly patients. The annual mortality rate of cerebrovascular events had increased, especially in the young-middle-aged group.