Annual survival of patients with end-stage chronic kidney disease on supportive hemodialysis and its correlates.

Abstract

Objective: Aim: The aim of the study was to determine the relationship of residual renal function, markers of inflammation and protein-energy expenditure with annual survival in patients undergoing hemodialysis.

Patients and methods: Materials and Methods: The work was a prospective cohort study and included 299 patient data. Residual kidney function was determined by urine volume of more than 250 ml per day to assess the effect. According to this criterion, the patients were divided into two groups. The degree of chronic inflammation was assessed by the content of acute phase proteins (ferritin and C-reactive protein) in the blood serum. The serum albumin level was chosen as a marker of protein-energy expenditure. The survival rate of patients with residual renal function was higher as compared to patients without it (p<0.001).

Results: Results: In the current study, the absence of residual kidney function increased the risk of mortality from all causes in patients who had recently undergone hemodialysis by almost 30 times during the first year of substitution therapy. C-reactive protein was also associated with poorer survival in these patients (HR=1.01; 95% CI: 1-1.02), while albumin was inversely associated with mortality (HR=0.92; 95% CI: 0.87-0.98).

Conclusion: Conclusions: Thus, residual renal function and higher serum albumin levels by the time maintenance hemodialysis begins are independent predictors of the best survival during the first year of replacement therapy. The presence of residual kidney function of less than 250 ml and a higher level of C-reactive protein correlated with an increased risk of mortality in these patients.