Biomarkers associated with mortality in patients undergoing dialysis.

Abstract

Survival for patients commencing renal replacement therapy is around 90% in the first year and 83% at two years after starting dialysis. The factors that appear to predict mortality are comorbidity and frailty associated with kidney disease, glomerular filtration rate, age and biochemical factors. To analyse the condition of patients starting renal replacement therapy, based on biomarkers commonly used in clinical practice and their association with mortality, measured 6 and 12 months after initiating replacement therapy. A one-year prospective follow-up study with 189 patients. Sociodemographic variables, aetiology of renal disease, comorbidities, prior nephrology service monitoring, prior renal transplantation and biochemical parameters at the time of initiating replacement therapy were analysed. The overall percentage of death during the one-year follow-up was 6.87%, with 64% of deaths occurring during the first six months. The only variable independently associated with mortality was low albumin levels. Although most patients in this centre are monitored by a nephrologist prior to starting replacement therapy, many nevertheless fail to achieve the biochemical targets recommended. One such parameter is albumin, which proved at the start of replacement therapy to be an independent predictor of mortality. Findings of this study show the need to intervene on certain biochemical parameters during the pre-dialysis stage and at the start of dialysis, in order to improve survival in this group of patients.