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Predictive role of fluctuating biochemical parameters for mortality in hemodialysis patients
Nils Mülling1, Jan Ter Huurne1, Anna Lena Kahl2
1Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Introduction:
High inflammation parameters like C-reactive protein and low albumin levels are considered as risk factors in CKD stage 5 patients. Due to dynamic changes in these parameters, there is evidence of an association between their variation and mortality in hemodialysis patients.
Methods:
We retrospectively analyzed 153 patients on chronic hemodialysis. Dialysis-specific biochemical parameters were measured at three-month intervals over a 42-month period. Fluctuations were calculated as the percentage change in two subsequent measurements.
Results:
Median age was 70 years. 41.10% of the patients died over the study period. Higher fluctuation rates in albumin and CRP were significantly associated with a higher mortality rate. Regression analysis revealed that only the fluctuations in albumin proved to be a predictive variable for the end point "death." If the fluctuation in albumin increases by 1%, the mortality risk rises by 22%.
Conclusion:
Fluctuations in albumin are of predictive importance in patients on chronic hemodialysis.
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