Predictive role of fluctuating biochemical parameters for mortality in hemodialysis patients

Abstract

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.

Phosphate kinetic modeling as an estimate of daily ingested phosphate in hemodialysis patients with or without residual kidney function

“…It causes secondary hyperparathyroidism and renal osteodystrophy [1]. Hyperphosphatemia is a significant risk factor for all-cause and cardiovascular (CV) mortality in dialysis patients [2,3]. P balance in hemodialysis (HD) patients is often evaluated based on a monthly P level measured before the HD session.…”