The Effect of Anemia and Hypoalbuminemia on Six-Months Hospitalization Risk in End Stage Chronic Kidney Disease Patients Undergoing Hemodialysis: A Retrospective Cohort Study.
Octavianus Umboh, Emma Syarifih Moies, Stella Palar
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引用次数: 0
Abstract
Background: Chronic kidney disease (CKD) patients, particularly those who require renal replacement therapy, have a higher risk of hospitalization and mortality compared than the general population. The patients can suffer hypoalbuminemia and anemia due to chronic inflammations, that might affect the risk of hospitalization risk. The aim of this study is to investigate the effect of albumin dan hemoglobin levels on the hospitalization incidence of patients with stage 5 chronic kidney disease who undergo chronic hemodialysis.
Methods: This retrospective cohort study enrolled patients aged 18 years and older with end stage kidney disease who underwent regular hemodialysis at the Prof. dr. R. D Kandou Hospital, Manado, Indonesia. Patients with malignancy were excluded. We measured the hemoglobin and albumin baseline level and observed the hospitalization incidence over the next 6 months. We used the Chi Square test with significance level of p-value 0.05, to analyze the association between both anemia and hypoalbuminemia with risk of hospitalization over 6 months of follow up period.
Results: We enrolled 202 patients as our participants, most of whom were men (61.8%), with a mean age of 60.21±9.32 years. There were 120 participants (59.4%) being hospitalized during 6-months-follow-up period. The mean level of albumin was 3.29±0.63 g/dl, while the mean hemoglobin level was 9.43±1.75 g/dl. This study found that most of the participants had hypoalbuminemia (62.9%) while 45% had anemia. We found significant associations between hypoalbuminemia and anemia with the risk of hospitalization within 6 months, with p values 0.001 and 0.007, respectively. The relative risk for being hospitalized over 6 months follow up period in patients having anemia was 2.32 (95% CI 1.29-4.17), and for hypoalbuminemia was 2.77 (95% CI 1.54-4.99).
Conclusion: Hypoalbuminemia and anemia are associated with increased risk of all causes hospitalization within 6 months in stage 5 chronic kidney disease patients undergoing hemodialysis.
背景:慢性肾脏疾病(CKD)患者,特别是那些需要肾脏替代治疗的患者,与普通人群相比,住院和死亡的风险更高。患者可因慢性炎症而出现低白蛋白血症和贫血,可能影响住院风险。本研究旨在探讨白蛋白和血红蛋白水平对慢性肾脏疾病5期慢性血液透析患者住院发生率的影响。方法:本回顾性队列研究纳入了18岁及以上的终末期肾病患者,这些患者在印度尼西亚万鸦老的dr. R. D . Kandou医院接受定期血液透析。排除恶性肿瘤患者。我们测量了血红蛋白和白蛋白基线水平,并观察了接下来6个月的住院发生率。我们采用χ 2检验,p值为0.05,分析6个月随访期间贫血和低白蛋白血症与住院风险的关系。结果:我们招募了202例患者作为研究对象,其中大多数为男性(61.8%),平均年龄为60.21±9.32岁。有120名参与者(59.4%)在6个月的随访期间住院。白蛋白平均值为3.29±0.63 g/dl,血红蛋白平均值为9.43±1.75 g/dl。该研究发现,大多数参与者患有低白蛋白血症(62.9%),45%患有贫血。我们发现低白蛋白血症和贫血与6个月内住院风险之间存在显著关联,p值分别为0.001和0.007。贫血患者随访6个月以上住院的相对危险度为2.32 (95% CI 1.29-4.17),低白蛋白血症患者住院的相对危险度为2.77 (95% CI 1.54-4.99)。结论:低白蛋白血症和贫血与接受血液透析的5期慢性肾病患者6个月内全因住院的风险增加相关。
期刊介绍:
Acta Medica Indonesiana – The Indonesian Journal of Internal Medicine is an open accessed online journal and comprehensive peer-reviewed medical journal published by the Indonesian Society of Internal Medicine since 1968. Our main mission is to encourage the novel and important science in the clinical area in internal medicine. We welcome authors for original articles (research), review articles, interesting case reports, special articles, clinical practices, and medical illustrations that focus on the clinical area of internal medicine. Subjects suitable for publication include, but are not limited to the following fields of: -Allergy and immunology -Emergency medicine -Cancer and stem cells -Cardiovascular -Endocrinology and Metabolism -Gastroenterology -Gerontology -Hematology -Hepatology -Tropical and Infectious Disease -Virology -Internal medicine -Psychosomatic -Pulmonology -Rheumatology -Renal and Hypertension -Thyroid