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Disease Markers
Volume 35, Issue 6, Pages 791–798
http://dx.doi.org/10.1155/2013/518945
Research Article

Risk Factors for Mortality in Hemodialysis Patients: Two-Year Follow-Up Study

1Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
2Nephrocare Portugal, SA-Nephrocare Maia, Maia, Portugal
3Laboratório de Bioquímica, Departamento de Ciências Biológicas, Faculdade Farmácia, Universidade do Porto, Porto, Portugal
4Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Porto, Portugal
5Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
6Centro Investigação Ciências Saúde, Universidade Beira Interior, Covilhã, Portugal
7IBILI, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
8Serviço de Bioquímica, Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal

Received 24 January 2013; Accepted 2 May 2013

Academic Editor: Sudhir Srivastava

Copyright © 2013 Maria do Sameiro-Faria et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. 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. Methods and Results. 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. Results. 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). Conclusions. The use of CVC, high CRP, and low TG values seem to be independent risk factors for mortality in HD patients.