Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal ; Nephrocare Portugal, SA-Nephrocare Maia, Maia, Portugal.
Laboratório de Bioquímica, Departamento de Ciências Biológicas, Faculdade Farmácia, Universidade do Porto, Porto, Portugal ; Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Porto, Portugal.
Dis Markers. 2013;35(6):791-8. doi: 10.1155/2013/518945. Epub 2013 Nov 24.
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.
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.
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).
The use of CVC, high CRP, and low TG values seem to be independent risk factors for mortality in HD patients.
接受血液透析（HD）的终末期肾病（ESRD）患者死亡率较高。这些患者存在炎症、血脂异常、红细胞生成、铁代谢、内皮功能和营养状况紊乱。我们的目的是通过进行为期两年的随访研究，确定这些紊乱与死亡之间是否存在显著关联。
从 189 名 HD 患者（55.0%为男性；66.4±13.9 岁）中获得了大量数据，包括血液学数据、血脂谱、铁代谢、营养、炎症和内皮（功能）紊乱标志物以及透析充分性。
在随访期间有 35 名患者（18.5%）死亡。我们的数据表明，血管通路类型、C 反应蛋白（CRP）和甘油三酯（TG）是死亡的显著预测因子。与使用中心静脉导管（CVC）的患者相比（危险比 [HR] = 3.03，95%置信区间 [CI] = 1.49-6.13），使用 CVC 的患者死亡风险更高，且 CRP 水平较高（第四四分位）（HR = 17.3，95% CI = 2.40-124.9）。与 TG 水平较低（第一四分位）的患者相比，TG 水平较高（第四四分位）的患者死亡风险较低（HR = 0.18，95% CI = 0.05-0.58）。
CVC 的使用、高 CRP 和低 TG 值似乎是 HD 患者死亡的独立危险因素。
