Association Between Hemodiafiltration and Hypoalbuminemia in Middle-Age Hemodialysis Patients

作者:Weng Cheng Hao; Hsu Ching Wei; Hu Ching Chih; Yen Tzung Hai; Huang Wen Hung*
来源:Medicine, 2016, 95(15): e3334.
DOI:10.1097/MD.0000000000003334

摘要

The advantage of hemodiafiltration (HDF) is well known. One of the disadvantages of HDF is loss of serum albumin, but this issue is still obscure. Some risk factors associated with mortality were age dependent. Studies on serum albumin/hypoalbuminemia and HDF in different age stratification were limited. The aim of this cross-sectional study was to assess the role of IMF and other clinical variables on serum albumin values in maintenance hemodialysis (MHD) patients of different age groups. We recruited a total of 1216 patients on MHD. Patients were divided into 4 groups by age stratification of youth ( <30 years old), young middle age (30-44 years old), middle age (45-64 years old), and old age (>= 65 years old). Biochemical, hematological, nutritional, inflammatory parameters, and receiving HDF or not were recorded. The associations between age groups, HDF, and variables mentioned above were analyzed. Only in middle-age group, patients with TIDE was significantly (P = 0.013) associated with serum albumin <4 g/dL. In middle-age group, a multivariate-forward logistic regression analysis showed that male sex (2.169 [1.029, 4.574], P = 0.042), inflammation (4.167 [2.043, 8.498], P < 0.001), cardiovascular disease (2.92 [1.019, 8.402], P = 0.046), serum creatinine level (0.639 [0.538, 0.758], P < 0.001), and cholesterol level (0.984 [0.975, 0.993], P = 0.001) were associated with serum albumin level <3.6 g/dL. hepatitis C virus infection (1.911 [1.186, 3.077], P = 0.008), IlDF (2.143 [1.298, 3.540], P = 0.003), inflammation (2.309 [1.549, 3.440], P < 0.001), use of arterio-venous fistula (0.518 [0.327, 0.820], P = 0.005), KIN (0.395 [0.193, 0.809], P = 0.011), nonanuria (0.542 [0.337, 0.870], P = 0.011), serum creatinine level (0.744 [0.669, 0.828], P < 0.001), and cholesterol level (0.993 [0.987, 0.998], P = 0.013) were associated with serum albumin level <4 OIL. HDF can predict serum albumin level <4 g/dL in middle-age HD patients. The effect of age needs to be taken into consideration when interpreting the correlation between hypoalbuminemia and HDF.

  • 出版日期2016-4
  • 单位长春大学