Cohort (n=87)
No
Malnutrition (lower serum albumin) and inflammation (higher C-reactive protein) are significant predictors of mortality in incident hemodialysis patients with chronic cardiorenal syndrome.
Hypothesis-generating for targeting malnutrition or inflammation; should not yet change practice in cardiorenal syndrome on dialysis.
BACKGROUND/AIMS: A significant number of uremic patients develop ischemic heart disease before hemodialysis (HD) is initiated. Recently, chronic cardiorenal syndrome among predialysis patients has been recognized. However, little is known about prognostic factors in this subgroup of incident HD patients. METHODS: A total of 87 incident HD patients, who were classified into cardiorenal syndrome type 4 (chronic cardiorenal syndrome), were identified at Mitsui Memorial Hospital between 1984 and 2003. The survival and risk factors for mortality were examined. RESULTS: 25 patients died and the 5-year survival rate amounted to approximately 75%. Both all-cause mortality and the adjusted mortality for age and sex were higher in patients with a lower serum albumin level (p = 0.03) or higher serum C-reactive protein level (p = 0.02). CONCLUSION: The poor survival rate of incident HD patients with a medical history of ischemic heart disease was predicted by malnutrition and inflammation at the start of HD.
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Mimura et al. (2011) conducted a cohort in Cardiorenal syndrome type 4 (chronic cardiorenal syndrome) (n=87). Lower serum albumin and higher serum C-reactive protein vs. Higher serum albumin and lower serum C-reactive protein was evaluated on All-cause mortality (p=0.03 for albumin, 0.02 for CRP).
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