Prealbumin is the best nutritional predictor of survival in hemodialysis and peritoneal dialysis
| Autor: | Marta Blanco, M M Avram, Rajesh Batish, Mathew M. Avram, Neal Mittman, Rajanna Sreedhara |
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| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Population Nutritional Status Gastroenterology Peritoneal dialysis Cohort Studies chemistry.chemical_compound Renal Dialysis Risk Factors Internal medicine medicine Humans Prealbumin education Survival rate Serum Albumin Proportional Hazards Models Uremia Creatinine education.field_of_study Proportional hazards model business.industry Middle Aged medicine.disease Survival Rate Cholesterol Endocrinology chemistry Nephrology Hemodialysis business Peritoneal Dialysis Kidney disease |
| Zdroj: | American Journal of Kidney Diseases. 28:937-942 |
| ISSN: | 0272-6386 |
| DOI: | 10.1016/s0272-6386(96)90398-4 |
| Popis: | Patients undergoing dialytic therapy for end-stage renal disease (ESRD) have greater morbidity and mortality than age-matched individuals with similar demographics in the general population. Risk factors for early death during treatment for ESRD include advanced age, diabetes, hypertension, and malnutrition. We questioned whether the level of serum prealbumin at the start of uremia therapy might serve as a marker of subsequent survival in patients treated with maintenance hemodialysis (HD) and peritoneal dialysis (PD). Study cohorts included 111 HD and 78 PD patients followed for up to 5 years. Selected demographic characteristics and biochemical variables were tested for correlation with survival in each cohort. Variables evaluated included age, race, gender, diabetic status, and serum concentrations of albumin, creatinine, cholesterol, and prealbumin. For comparison, expected survival was calculated with Cox proportional hazards analysis, which accounts for confounding variables. We found that a higher relative risk (RR) of death in HD patients correlated with older age, the diagnosis of diabetes, and a serum prealbumin < 30 mg/dL. In PD patients, older age and the presence of diabetes correlated with a higher RR of death than in the standard population. When nutritional variables were analyzed separately, prealbumin < 30 mg/dL was the strongest variable that predicted mortality in HD patients (RR = 2.64, P = 0.002) and also predicted increased risk of mortality in PD patients (RR = 1.8, P = 0.035). Observed and expected survival was significantly higher in patients with enrollment prealbumin greater than 30 mg/dL in both HD and PD. The serum prealbumin level correlated significantly with other measures of nutrition, including serum albumin, serum creatinine, and serum cholesterol, in both HD and PD patients. Among tested markers of nutritional status, prealbumin level appears to be the single best nutritional predictor of survival in ESRD patients. |
| Databáze: | OpenAIRE |
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