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Impact of serum albumin and body-mass index on survival in hemodialysis patients

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Abstract

A low body mass index (BMI) and serum albumin are associated with increased risk of mortality in patients with chronic kidney disease (CKD). The purpose of this study was to evaluate BMI and serum albumin as predictors of all-cause and cardiovascular (CV) mortality in hemodialysed (HD) patients. We describe the results of a five-year retrospective observational study with 187 HD patients (54.9 ± 15.6 years old, 54% men, and 46% suffering from diabetes) from RenalCor Clinic in Rio de Janeiro, Brazil. The influence of serum albumin levels and BMI (determined every three months) over all-cause mortality was examined using a Cox model, while the influence of the same factors over CV mortality among all-cause mortality was modeled through a logistic regression. During the five years, 26.7% of the patients died, 62% of which due to CV disease (CVD). Analysis by the Cox model showed that low serum albumin and low BMI were significant predictors of mortality. Patients with higher BMI had a lower hazard of death for all-cause mortality (hazard ratio [HR] = 0.92; P  = 0.035) and a 1 g/l increase in serum albumin was associated with significantly lower hazard of death (hazard ratio = 0.9679; P < 0.001). The highest BMI value (>30 kg/m2) was significantly associated with an increase of odds of CV mortality (odds ratio = 1.22, P = 0.03). We confirm here in a Brazilian cohort of hemodialysis patients that both low BMI (<19 kg/m2) and hypoalbuminemia are strong predictors of death.

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Acknowledgments

We would like to thank Álvaro A.F. Pereira for his help in editing the manuscript.

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Authors and Affiliations

  1. Clinical Nutrition Department, Nutrition Faculty, Federal University Fluminense (UFF), Niteroi, Brazil

    Denise Mafra, Daniele Lima Azevedo, Giselle Gomide Viana & Juliana Pires Mattos

  2. RenalCor Clinic, Rio de Janeiro, Brazil

    Najla Elias Farage

  3. Statistical Department, Federal University Fluminense (UFF), Niteroi, Brazil

    Luis Guillermo Coca Velarde

  4. Department of Nephrology, Hôpital E.Herriot, Lyon, 69437, France

    Denis Fouque

  5. R. Theodor Herzl, 56 apto 103, Botafogo, Rio de Janeiro, RJ, 22260-030, Brazil

    Denise Mafra

Authors
  1. Denise Mafra
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  2. Najla Elias Farage
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  3. Daniele Lima Azevedo
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  4. Giselle Gomide Viana
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  5. Juliana Pires Mattos
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  6. Luis Guillermo Coca Velarde
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  7. Denis Fouque
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Correspondence to Denise Mafra.

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Mafra, D., Farage, N.E., Azevedo, D.L. et al. Impact of serum albumin and body-mass index on survival in hemodialysis patients. Int Urol Nephrol 39, 619–624 (2007). https://doi.org/10.1007/s11255-007-9201-2

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  • DOI: https://doi.org/10.1007/s11255-007-9201-2

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