Abstract
Serum albumin had been noted to be a predictor of mortality in hemodialysis (HD) patients. Normalized protein catabolic rate (nPCR) less than 0.8 or greater than 1.4 g/kg/d was also associated with greater mortality. There was no previous study to show the effectiveness of combination of serum albumin and nPCR to predict the mortality in chronic HD patients. Eight hundred and sixty-six patients were divided into 4 groups according to their nPCR and serum albumin levels. Biochemical, and hematological parameters were recorded. The associations between groups, variables mentioned above and mortality were analyzed. Multivariate Cox regression analysis showed that age, diabetes mellitus, fistula as blood access, nPCR <1.2 g/kg/day combined with albumin <4 (Group A), nPCR ≧ 1.2 g/kg/day combined with albumin <4 g/dL (Group B) (nPCR ≧ 1.2 g/kg/day combined with Albumin ≧ 4 g/dL as reference group), non-anuria, hemoglobin, creatinine, and log (high sensitivity C reactive protein) were correlated with 36 months mortality. Group A and group B patients had higher 36 months cardiovascular (CV) and infection related mortality rates as compared with group D patients. In conclusion, Group A and Group B patients had significantly higher rate of all-cause, CV and infection related mortality.
Highlights
HD duration (OR = 0.960 95% confidence Intervals (CI) = 0.922–0.999, P = 0.045), fistula as blood access (OR = 0.437, 95% CI = 0.293–0.653, P < 0.001), hemodiafiltration (OR = 0.551 95% CI = 0.314–0.967, P = 0.038), normalized protein catabolic rate (nPCR)
CI = 1.352–5.353, P = 0.005), non-anuria (OR = 0.305, 95% CI = 0.148–0.627, P = 0.001), WBC > 10000/μL (OR = 2.520, 95% CI = 1.225– 5.184, P = 0.012), Hb (OR = 0.750, 95% CI = 0.649–0.866, P < 0.001), serum Cr (OR = 0.709, 95% CI = 0.649– 0.775, P < 0.001), phosphate (OR = 0.706, 95% CI = 0.605–0.824, P < 0.001), Log ferritin (OR = 1.892, 95% CI = 1.187–3.017, P = 0.007), Log intact parathyroid hormone (iPTH) (OR = 0.582, 95% CI = 0.422–0.764, P < 0.001), and Log high sensitivity C reactive protein (hsCRP) (OR = 2.900, 95% CI = 1.976–4.257, P < 0.001) were correlated with 24 months mortality (Table 2)
Our present study showed that long term HD patients with nPCR
Summary
Multivariate Cox regression analysis showed that age (OR = 1.052, 95% CI = 1.036–1.068, P < 0.001), DM (OR = 1.661, 95% CI = 1.78–2.340, P = 0.004), fistula as blood access (OR = 0.620, 95% CI = 0.439–0.874, P = 0.006), nPCR
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have