Predictive role of fluctuating biochemical parameters for mortality in hemodialysis patients

Introduction: High inflammation parameters like C-reactive protein and low albumin levels are considered as risk factors in CKD stage 5 patients. Due to dynamic changes in these parameters, there is evidence of an association between their variation and mortality in hemodialysis patients.

Methods: We retrospectively analyzed 153 patients on chronic hemodialysis. Dialysis-specific biochemical parameters were measured at three-month intervals over a 42-month period. Fluctuations were calculated as the percentage change in two subsequent measurements.

Results: Median age was 70 years. 41.10% of the patients died over the study period. Higher fluctuation rates in albumin and CRP were significantly associated with a higher mortality rate. Regression analysis revealed that only the fluctuations in albumin proved to be a predictive variable for the end point "death." If the fluctuation in albumin increases by 1%, the mortality risk rises by 22%.

Conclusion: Fluctuations in albumin are of predictive importance in patients on chronic hemodialysis.