Salomone M, Piccoli G B, Bonello F, Torazza M C, Maffei S, Iadarola G M, Cardelli R, Cavalli P L, Quarello F, Triolo G
Servizio di Nefrologia e Dialisi, Ospedale Maggiore di Chieri, Università degli Studi di Torino.
Minerva Urol Nefrol. 1994 Mar;46(1):37-41.
In recent years, the availability of large epidemiological series allowed identification of biochemical outcome markers in the dialysis population. Interest towards albumin and cholesterol levels is motivated by their easy availability and by the presence of a strong short-term effect on mortality and morbidity. The aim of the study was an analysis of the relationship between albumin and cholesterol levels at start of dialysis and mortality (gross mortality and Kaplan Meier survival curves). Data were obtained from the Piedmont Regional Registry of Dialysis and Transplantation (Northern Italy Region, about 4,400,000 inhab, 20 Dialysis Centers, open acceptance since mid '70, yearly information on 100% of patients) in the period 1981-1990 (4734 patients on file). Only non diabetic patients with follow-up > = 1 month, who started treatment in the Region, were selected. Patients with renal function recovery were excluded. Albumin levels were dichotomized at 3.5 g/dl. Cholesterol was stratified into 3 levels (< 150, 150-250, > or = 300 mg/dl). The choice of dividing the study into 2 periods (1980-1985 vs 1986-1990) is due to the fact that 1984 has been the year of switch from acetate to bicarbonate dialysis. Prevalence of albumin and cholesterol under the normal range (22% and 15%) is low and rises with age and presence of high risk conditions. A a good correlation with the risk of death of these biochemical markers (stronger for albumin at least in the short term) was observed. No correlations are found with risk of death and elevated cholesterol levels (low number of cases).(ABSTRACT TRUNCATED AT 250 WORDS)
近年来，大量流行病学系列研究的开展使得在透析人群中识别生化结局标志物成为可能。对白蛋白和胆固醇水平的关注源于它们易于获取，以及对死亡率和发病率有强烈的短期影响。本研究的目的是分析透析开始时白蛋白和胆固醇水平与死亡率（总死亡率和Kaplan-Meier生存曲线）之间的关系。数据来自皮埃蒙特地区透析与移植登记处（意大利北部地区，约440万居民，20个透析中心，自70年代中期起接受所有患者，每年收集100%患者的信息），时间跨度为1981年至1990年（存档患者4734例）。仅选择在该地区开始治疗、随访时间≥1个月的非糖尿病患者。肾功能恢复的患者被排除。白蛋白水平以3.5 g/dl为界进行二分法划分。胆固醇分为3个水平（<150、150 - 250、≥300 mg/dl）。将研究分为两个时期（1980 - 1985年与1986 - 1990年）是因为1984年是从醋酸盐透析转换为碳酸氢盐透析的年份。白蛋白和胆固醇低于正常范围的患病率较低（分别为22%和15%），且随年龄和高危情况的出现而升高。观察到这些生化标志物与死亡风险有良好的相关性（至少在短期内白蛋白的相关性更强）。未发现胆固醇水平升高与死亡风险之间存在相关性（病例数较少）。（摘要截断于250字）
