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The overall results of hemodialysis are not good with a 90%, 5-year death rate in most Western countries. Several self-evident variables: age, diagnosis, and comorbidity predict death but there are inexplicable individual variations. The usual measure of hemodialysis, “Kt/V” has been useless in predicting mortality. We speculated that it would be most important to study individual stress reactions to dialysis. We measured two important peptides measuring stress: ANP and NPY and created a stress index = (ANP + 3 × NPY). ANP reacts to the stress of fluid overload and NPY reacts to fluid overload, blood pressure and nervous overactivity. The stress index was measured in 33 patients that were followed for up to 12 years. All 12 patients (HSI) with a stress index above the mean of 275 ng/l died compared to 6/21 of patients (LSI) with an index below mean p |
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