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Risk Factors for Mortality in Hemodialysis Patients: Two-Year Follow-Up Study

机译:血液透析患者死亡率的危险因素:两年随访研究

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摘要

Background. End-stage renal disease (ESRD) patients under hemodialysis (HD) have high mortality rate. Inflammation, dyslipidemia, disturbances in erythropoiesis, iron metabolism, endothelial function, and nutritional status have been reported in these patients. Our aim was to identify any significant association of death with these disturbances, by performing a two-year follow-up study. Methods and Results. A large set of data was obtained from 189 HD patients (55.0% male; 66.4 ± 13.9 years old), including hematological data, lipid profile, iron metabolism, nutritional, inflammatory, and endothelial (dys)function markers, and dialysis adequacy. Results. 35 patients (18.5%) died along the follow-up period. Our data showed that the type of vascular access, C-reactive protein (CRP), and triglycerides (TG) are significant predictors of death. The risk of death was higher in patients using central venous catheter (CVC) (Hazard ratio [HR] =3.03, 95% CI = 1.49–6.13), with higher CRP levels (fourth quartile), compared with those with lower levels (first quartile) (HR = 17.3, 95% CI = 2.40–124.9). Patients with higher TG levels (fourth quartile) presented a lower risk of death, compared with those with the lower TG levels (first quartile) (HR = 0.18, 95% CI = 0.05–0.58). Conclusions. The use of CVC, high CRP, and low TG values seem to be independent risk factors for mortality in HD patients.
机译:背景。血液透析(HD)的终末期肾脏病(ESRD)患者死亡率较高。据报道,这些患者有炎症,血脂异常,红细胞生成障碍,铁代谢,内皮功能和营养状况。我们的目的是通过进行为期两年的随访研究,确定死亡与这些障碍的任何重要关联。方法和结果。从189例HD患者(男性55.0%; 66.4±13.9岁)获得了大量数据,包括血液学数据,脂质分布,铁代谢,营养,炎症和内皮(功能障碍)标志物以及透析充分性。结果。随访期间死亡35例(18.5%)。我们的数据表明,血管通路的类型,C反应蛋白(CRP)和甘油三酸酯(TG)是死亡的重要预测因子。与较低水平的患者相比,使用中央静脉导管(CVC)的患者死亡风险更高(危险比[HR] = 3.03,95%CI = 1.49–6.13),较高的CRP水平(第四四分位数)。四分位数)(HR = 17.3,95%CI = 2.40–124.9)。 TG水平较高(第四四分位数)的患者与TG水平较低(第一四分位数)的患者相比,死亡风险较低(HR = 0.18,95%CI = 0.05-0.58)。结论。使用CVC,高CRP和低TG值似乎是HD患者死亡的独立危险因素。

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