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Hypoalbuminaemia and One-Year Mortality in Haemodialysis Patients with Heart Failure: A Cohort Analysis

Introduction: The prevalence of chronic kidney disease (CKD) and heart failure (HF) has been rising over the past decade, with a prevalence close to 40%. Cardiovascular disease and malnutrition are common comorbidities and known risk factors for mortality in haemodialysis (HD) patients. We aimed to...

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Autores principales: Cardoso, Ana, Branco, Carolina, Sant’Ana, Mariana, Costa, Cláudia, Silva, Bernardo, Fonseca, José, Outerelo, Cristina, Gameiro, Joana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509659/
https://www.ncbi.nlm.nih.gov/pubmed/34640538
http://dx.doi.org/10.3390/jcm10194518
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author Cardoso, Ana
Branco, Carolina
Sant’Ana, Mariana
Costa, Cláudia
Silva, Bernardo
Fonseca, José
Outerelo, Cristina
Gameiro, Joana
author_facet Cardoso, Ana
Branco, Carolina
Sant’Ana, Mariana
Costa, Cláudia
Silva, Bernardo
Fonseca, José
Outerelo, Cristina
Gameiro, Joana
author_sort Cardoso, Ana
collection PubMed
description Introduction: The prevalence of chronic kidney disease (CKD) and heart failure (HF) has been rising over the past decade, with a prevalence close to 40%. Cardiovascular disease and malnutrition are common comorbidities and known risk factors for mortality in haemodialysis (HD) patients. We aimed to evaluate the one-year mortality rate after dialysis induction, and the impact of serum albumin levels on survival outcomes, in patients with CKD and HF. Methods: This was a retrospective analysis of patients with CKD and HF who underwent chronic HD between January 2016 and December 2019 in a tertiary-care Portuguese hospital. Variables were submitted to univariate and multivariate analysis to determine factors predictive of one-mortality after HD start. Results: In total, 204 patients were analysed (mean age 75.1 ± 10.3 years). Within the first year of HD start, 28.7% of patients died. These patients were significantly older [79.8 ± 7.2 versus 72.9 ± 10.9 years, p < 0.001; OR 1.08 (1.04–1.13), p < 0.001] and had a higher mean Charlson Index [9.0 ± 1.8 versus 8.3 ± 2.0, p = 0.015; OR 1.22 (1.04–1.44), p = 0.017], lower serum creatinine [5.1 ± 1.6 mg/dL versus 5.8 ± 2.0 mg/dL; p = 0.021; OR 0.80 (0.65–0.97), p = 0.022], lower albumin levels [3.1 ± 0.6 g/dL versus 3.4 ± 0.6 g/dL, p < 0.001; OR 0.38 (0.22–0.66), p = 0.001] and started haemodialysis with a central venous catheter more frequently [80.4% versus 66.2%, p = 0.050]. Multivariate analysis identified older age [aOR 1.07 (1.03–1.12), p = 0.002], lower serum creatinine [aOR 0.80 (0.64–0.99), p = 0.049] and lower serum albumin [aOR 0.41 (0.22–0.75), p = 0.004] as predictors of one-year mortality. Conclusion: In our cohort, older age, lower serum creatinine and lower serum albumin were independent risk factors for one-year mortality, highlighting the prognostic importance of malnutrition in patients starting chronic HD.
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spelling pubmed-85096592021-10-13 Hypoalbuminaemia and One-Year Mortality in Haemodialysis Patients with Heart Failure: A Cohort Analysis Cardoso, Ana Branco, Carolina Sant’Ana, Mariana Costa, Cláudia Silva, Bernardo Fonseca, José Outerelo, Cristina Gameiro, Joana J Clin Med Article Introduction: The prevalence of chronic kidney disease (CKD) and heart failure (HF) has been rising over the past decade, with a prevalence close to 40%. Cardiovascular disease and malnutrition are common comorbidities and known risk factors for mortality in haemodialysis (HD) patients. We aimed to evaluate the one-year mortality rate after dialysis induction, and the impact of serum albumin levels on survival outcomes, in patients with CKD and HF. Methods: This was a retrospective analysis of patients with CKD and HF who underwent chronic HD between January 2016 and December 2019 in a tertiary-care Portuguese hospital. Variables were submitted to univariate and multivariate analysis to determine factors predictive of one-mortality after HD start. Results: In total, 204 patients were analysed (mean age 75.1 ± 10.3 years). Within the first year of HD start, 28.7% of patients died. These patients were significantly older [79.8 ± 7.2 versus 72.9 ± 10.9 years, p < 0.001; OR 1.08 (1.04–1.13), p < 0.001] and had a higher mean Charlson Index [9.0 ± 1.8 versus 8.3 ± 2.0, p = 0.015; OR 1.22 (1.04–1.44), p = 0.017], lower serum creatinine [5.1 ± 1.6 mg/dL versus 5.8 ± 2.0 mg/dL; p = 0.021; OR 0.80 (0.65–0.97), p = 0.022], lower albumin levels [3.1 ± 0.6 g/dL versus 3.4 ± 0.6 g/dL, p < 0.001; OR 0.38 (0.22–0.66), p = 0.001] and started haemodialysis with a central venous catheter more frequently [80.4% versus 66.2%, p = 0.050]. Multivariate analysis identified older age [aOR 1.07 (1.03–1.12), p = 0.002], lower serum creatinine [aOR 0.80 (0.64–0.99), p = 0.049] and lower serum albumin [aOR 0.41 (0.22–0.75), p = 0.004] as predictors of one-year mortality. Conclusion: In our cohort, older age, lower serum creatinine and lower serum albumin were independent risk factors for one-year mortality, highlighting the prognostic importance of malnutrition in patients starting chronic HD. MDPI 2021-09-29 /pmc/articles/PMC8509659/ /pubmed/34640538 http://dx.doi.org/10.3390/jcm10194518 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Cardoso, Ana
Branco, Carolina
Sant’Ana, Mariana
Costa, Cláudia
Silva, Bernardo
Fonseca, José
Outerelo, Cristina
Gameiro, Joana
Hypoalbuminaemia and One-Year Mortality in Haemodialysis Patients with Heart Failure: A Cohort Analysis
title Hypoalbuminaemia and One-Year Mortality in Haemodialysis Patients with Heart Failure: A Cohort Analysis
title_full Hypoalbuminaemia and One-Year Mortality in Haemodialysis Patients with Heart Failure: A Cohort Analysis
title_fullStr Hypoalbuminaemia and One-Year Mortality in Haemodialysis Patients with Heart Failure: A Cohort Analysis
title_full_unstemmed Hypoalbuminaemia and One-Year Mortality in Haemodialysis Patients with Heart Failure: A Cohort Analysis
title_short Hypoalbuminaemia and One-Year Mortality in Haemodialysis Patients with Heart Failure: A Cohort Analysis
title_sort hypoalbuminaemia and one-year mortality in haemodialysis patients with heart failure: a cohort analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509659/
https://www.ncbi.nlm.nih.gov/pubmed/34640538
http://dx.doi.org/10.3390/jcm10194518
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