贫血和低白蛋白血症对接受血液透析的终末期慢性肾脏病患者 6 个月住院风险的影响：一项回顾性队列研究。

The Effect of Anemia and Hypoalbuminemia on Six-Months Hospitalization Risk in End Stage Chronic Kidney Disease Patients Undergoing Hemodialysis: A Retrospective Cohort Study.

机构信息

Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Sam Ratulangi University - Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia.

出版信息

Acta Med Indones. 2023 Apr;55(2):136-141.

PMID:37524595

Abstract

BACKGROUND

Chronic kidney disease (CKD) patients, particularly those who require renal replacement therapy, have a higher risk of hospitalization and mortality compared than the general population. The patients can suffer hypoalbuminemia and anemia due to chronic inflammations, that might affect the risk of hospitalization risk. The aim of this study is to investigate the effect of albumin dan hemoglobin levels on the hospitalization incidence of patients with stage 5 chronic kidney disease who undergo chronic hemodialysis.

METHODS

This retrospective cohort study enrolled patients aged 18 years and older with end stage kidney disease who underwent regular hemodialysis at the Prof. dr. R. D Kandou Hospital, Manado, Indonesia. Patients with malignancy were excluded. We measured the hemoglobin and albumin baseline level and observed the hospitalization incidence over the next 6 months. We used the Chi Square test with significance level of p-value 0.05, to analyze the association between both anemia and hypoalbuminemia with risk of hospitalization over 6 months of follow up period.

RESULTS

We enrolled 202 patients as our participants, most of whom were men (61.8%), with a mean age of 60.21±9.32 years. There were 120 participants (59.4%) being hospitalized during 6-months-follow-up period. The mean level of albumin was 3.29±0.63 g/dl, while the mean hemoglobin level was 9.43±1.75 g/dl. This study found that most of the participants had hypoalbuminemia (62.9%) while 45% had anemia. We found significant associations between hypoalbuminemia and anemia with the risk of hospitalization within 6 months, with p values 0.001 and 0.007, respectively. The relative risk for being hospitalized over 6 months follow up period in patients having anemia was 2.32 (95% CI 1.29-4.17), and for hypoalbuminemia was 2.77 (95% CI 1.54-4.99).

CONCLUSION

Hypoalbuminemia and anemia are associated with increased risk of all causes hospitalization within 6 months in stage 5 chronic kidney disease patients undergoing hemodialysis.

摘要

背景

与普通人群相比，慢性肾脏病（CKD）患者，尤其是需要肾脏替代治疗的患者，住院和死亡风险更高。由于慢性炎症，这些患者可能会出现低白蛋白血症和贫血，这可能会影响住院风险。本研究旨在探讨 5 期慢性肾脏病行慢性血液透析患者的白蛋白和血红蛋白水平对住院发生率的影响。

方法

本回顾性队列研究纳入了在印度尼西亚万鸦老 Prof. dr. R. D Kandou 医院接受常规血液透析的年龄在 18 岁及以上的终末期肾病患者。排除恶性肿瘤患者。我们测量了血红蛋白和白蛋白的基线水平，并观察了接下来 6 个月的住院发生率。我们使用卡方检验，显著性水平为 p 值 0.05，分析了在 6 个月的随访期间，贫血和低蛋白血症与住院风险之间的关联。

结果

我们纳入了 202 名参与者，其中大多数为男性（61.8%），平均年龄为 60.21±9.32 岁。在 6 个月的随访期间，有 120 名（59.4%）参与者住院。白蛋白的平均水平为 3.29±0.63 g/dl，血红蛋白的平均水平为 9.43±1.75 g/dl。本研究发现，大多数参与者存在低白蛋白血症（62.9%），而 45%的参与者存在贫血。我们发现低白蛋白血症和贫血与 6 个月内住院风险显著相关，p 值分别为 0.001 和 0.007。在 6 个月的随访期间，患有贫血的患者住院的相对风险为 2.32（95%CI 1.29-4.17），而低白蛋白血症为 2.77（95%CI 1.54-4.99）。