The Prognostic Value of Soluble ST2 in Maintenance Hemodialysis Patients: A Meta-Analysis

2019 ◽  
Vol 49 (1-2) ◽  
pp. 114-120
Author(s):  
Shuang Wang ◽  
Fang Wei ◽  
Haiyan Chen ◽  
Zhe Wang ◽  
Ruining Zhang ◽  
...  
Keyword(s):  
Large Scale ◽  
Meta Analysis ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Mortality Hazard ◽  
Study Results ◽  
All Cause Mortality ◽  
Mortality Hazard Ratio ◽  
Maintenance Hemodialysis Patients

Background: Much controversy remains in the literature with respect to whether soluble suppression of tumorigenicity 2 (sST2) can serve to predict all-cause death in patients undergoing maintenance hemodialysis (MHD). This meta-analysis therefore sought to analyze extant datasets exploring the association between these 2 variables in MHD patients in order to draw relevant conclusions. Methods: Articles published through December 2018 in PubMed and Embase were independently reviewed by 2 authors to identify relevant articles, and STATA 12.0 was used for statistical analyses of relevant results and study parameters. Results: In total, we identified 4 relevant studies that were incorporated into this meta-analysis. These studies included a total of 1,924 participants (60% male, mean follow-up 911 days). The combined study results suggested that increased levels of sST2 were significantly linked to a 2.23 fold rise in all-cause mortality (hazard ratio [HR] 2.23, 95% CI 1.81–2.75). Subgroup analyses confirmed that this same association was true in patients undergoing hemodialysis (HR 2.17, 95% CI 1.74–2.71), which indicated that the increased levels of sST2 were significantly linked to a 2.17 fold rise in all-cause mortality. Conclusions: This analysis suggests that there is a significant link between elevated levels of sST2 and death in patients undergoing MHD. Further large-scale trials, however, will be needed to fully validate these findings and their clinical relevance.

β-blocker dialyzability and the risk of mortality and cardiovascular events in patients undergoing hemodialysis

2020 ◽  
Vol 35 (11) ◽  
pp. 1959-1965 ◽  
Author(s):  
Ping-Hsun Wu ◽  
Yi-Ting Lin ◽  
Mei-Chuan Kuo ◽  
Jia-Sin Liu ◽  
Yi-Chun Tsai ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Hemodialysis Patients ◽  
Major Adverse Cardiovascular Events ◽  
Coronary Syndrome ◽  
Mortality Hazard ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Β Blocker ◽  
Mortality Hazard Ratio

Abstract Background β-blocker (BB) dialyzability has been proposed to limit their efficacy among hemodialysis (HD) patients. We attempted to confirm this hypothesis by comparing health outcomes associated with the initiation of dialyzable or nondialyzable BBs in a nationwide cohort of HD patients. Methods We created a prospective cohort study of 15 699 HD patients who initiated dialyzable BBs (atenolol, acebutolol, metoprolol and bisoprolol) and 20 904 hemodialysis patients who initiated nondialyzable BBs (betaxolol, carvedilol and propranolol) between 2004 and 2011 in Taiwan healthcare. We compared the risk of all-cause mortality and major adverse cardiovascular events (MACEs, a composite of the acute coronary syndrome, ischemic stroke and heart failure) between users of dialyzable versus nondialyzable BBs during a 2-year follow-up. Results New users of dialyzable BBs were younger, more often men, with diabetes mellitus, hypertension and hyperlipidemia compared with users of nondialyzable BBs. Compared with nondialyzable BBs, initiation of dialyzable BBs was associated with lower all-cause mortality {hazard ratio [HR] 0.82 [95% confidence interval (CI) 0.75–0.88]} and lower risk of MACEs [HR 0.89 (95% CI 0.84–0.93)]. Results were confirmed in subgroup analyses, censoring at BB discontinuation or switch, after 1:1 propensity score matching, reclassifying bisoprolol or excluding bisoprolol/carvedilol users. Conclusions This study does not offer support for the hypothesis that the dialyzability of BBs reduces their efficacy in HD patients.

Sex-age-specific handgrip strength and mortality in an incident hemodialysis cohort: The risk explained by nutrition and comorbidities

2018 ◽  
Vol 41 (12) ◽  
pp. 825-832 ◽  
Author(s):  
Marcelo B Lopes ◽  
Luciana F Silva ◽  
Marina AS Dantas ◽  
Cacia M Matos ◽  
Gildete B Lopes ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Cox Regression ◽  
Handgrip Strength ◽  
Sociodemographic Factors ◽  
Hemodialysis Patients ◽  
Hazard Ratio ◽  
Maintenance Hemodialysis ◽  
Mortality Hazard ◽  
Mortality Hazard Ratio ◽  
Maintenance Hemodialysis Patients

Objective: To investigate associations of sex-age-specific handgrip strength by a dynamometer with all-cause mortality and the percent excess risk explained (%ERE) by comorbidities and nutritional indicators in incident maintenance hemodialysis patients. Methods: Prospective cohort of 413 adult patients (165 women, 248 men, 299 <60 years and 114 ⩾60 years) with <6 months (82% <3 months) on dialysis enrolled in PROHEMO in Salvador, Brazil. Low and high handgrip strength groups were based on sex-age-specific cutoffs (17.8 kg for women <60 years, 13.8 kg for women ⩾60 years, 29.5 kg for men <60 years, and 21.9 kg for men ⩾60 years). We used Cox regression to estimate the mortality hazard ratio. The %ERE was determined by the equation (HR1 – HR2)/(HR1 – 1) × 100, in which HR1 represented the hazard ratio in a model with a smaller number of covariates and HR2 represented the hazard ratio in a subsequent model with the inclusion of new covariates plus the variables included in the previous model. Results: The mortality hazard ratio comparing low and high handgrip strength was 2.58 (95% confidence interval: 1.73, 3.85) in the model with sociodemographic factors and vintage and 2.25 (95% confidence interval: 1.49, 3.43) with addition of comorbidities, corresponding to a %ERE of 21%. The hazard ratio was 1.98 (95% confidence interval: 1.29, 3.06) after addition of nutritional indicators corresponding to %ERE of 38%. Results stratified by age and gender followed similar patterns. Conclusion: These results provide support for the assessment of handgrip strength in all maintenance hemodialysis patients for early identification of those who may require special care to improve nutritional status and survival.

Abstract 4531: Statin Use Is Associated with Decreased Mortality in Persons with Peripheral Arterial Disease

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Himabindu Vidula ◽  
Lu Tian ◽  
Kiang Liu ◽  
Mary M McDermott
Keyword(s):  
Arterial Disease ◽  
Hazard Ratio ◽  
Mortality Hazard ◽  
All Cause Mortality ◽  
Interaction Term ◽  
Peripheral Arterial ◽  
Mortality Hazard Ratio ◽  
Statin Use ◽  
Cvd Mortality

We determined whether statin use was associated with lower all-cause and cardiovascular disease (CVD) mortality in persons with lower extremity peripheral arterial disease (PAD). We also determined whether favorable associations of statin use with mortality were stronger in persons with higher C-reactive protein (CRP) compared to those with lower CRP levels. Participants were 681 men and women with PAD from the Walking and Leg Circulation Study (WALCS) and WALCS II prospective cohort studies. Participants were identified from non-invasive vascular laboratories in Chicago. Participants attended a baseline visit and annual visits for a mean follow-up of 3.7 years. Statin use was determined at baseline and each annual visit. Outcome measures were all-cause and CVD mortality. Time dependent Cox regression analyses were used to evaluate associations of statin use and mortality. Analyses were also repeated separately in participants with baseline CRP values above vs. below the median for the cohort. Analyses were adjusted for age, sex, race, comorbid conditions, ankle brachial index, total cholesterol, high density lipoprotein cholesterol, and other confounders. One hundred fifty five (23%) persons died during follow-up. Two hundred ninety (43%) persons were on a statin at baseline. At baseline, median CRP level was 2.6 mg/L. Statin use was associated with significantly lower all-cause mortality (hazard ratio, 0.52 [95% CI, 0.31 to 0.88], P = 0.014) and CVD mortality (hazard ratio, 0.41 [95% CI, 0.17 to 0.99], P = 0.048) as compared to statin non-use. In persons with CRP >2.6 mg/L, statin use was associated with a significantly lower risk of all-cause mortality (hazard ratio, 0.44 [95% CI, 0.23 to 0.88], P = 0.019, interaction term P = 0.67) and CVD mortality (hazard ratio, 0.20 [95% CI, 0.06 to 0.65], P = 0.0075, interaction term P = 0.39). However, in persons with CRP < 2.6 mg/L, statin use was not associated with lower mortality. Among persons with PAD, statin use is associated with significantly lower all-cause and CVD mortality at mean follow-up of 3.7 years. This finding is largely attributable to favorable associations of statin use with lower mortality among PAD patients with elevated baseline CRP levels.

scholarly journals High Erythropoiesis Resistance Index Is a Significant Predictor of Cardiovascular and All-Cause Mortality in Chinese Maintenance Hemodialysis Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Xiangxue Lu ◽  
Jialing Zhang ◽  
Shixiang Wang ◽  
Qian Yu ◽  
Han Li
Keyword(s):  
Cardiovascular Mortality ◽  
Resistance Index ◽  
High Sensitivity ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
All Cause Mortality ◽  
Correlated Factors ◽  
Maintenance Hemodialysis Patients

Background. Renal anemia is a common complication of hemodialysis patients. Erythropoietin (EPO) hyporesponsiveness has been recognized as an important factor to poor efficacy of recombinant human erythropoietin in the treatment of renal anemia. More importantly, increased erythropoiesis resistance index (ERI) may be associated with inflammation and increased mortality. Objective. The objective of this research was to investigate correlated factors of EPO responsiveness and to clarify the relationships between EPO hyporesponsiveness and cardiovascular mortality and all-cause mortality among maintenance hemodialysis patients. Methods. This prospective cohort study enrolled 276 maintenance hemodialysis patients for a 55-month follow-up to investigate the factors related to ERI and its relationship to all-cause mortality and cardiovascular mortality. Results. ERI was positively correlated with predialysis serum high-sensitivity C-reactive protein ( r = 0.234 , p < 0.001 ), alkaline phosphatase ( r = 0.134 , p = 0.028 ), and ferritin ( r = 0.155 , p = 0.010 ) and negatively correlated with albumin ( r = − 0.206 , p < 0.001 ) and creatinine ( r = − 0.232 , p < 0.001 ). As multiple linear regression showed, predialysis serum albumin, high-sensitivity C-reactive protein, ferritin, and creatinine were independent correlated factors of ERI ( p < 0.05 ). Kaplan–Meier curves showed that the cumulative incidences of both cardiovascular mortality and all-cause mortality were significantly higher in patients with ERI > 11.04   IU / kg / w / g / dL (both p < 0.01 ). The high ERI group was significantly associated with higher risk for all-cause mortality (OR 1.781, 95% CI 1.091 to 2.910, p = 0.021 ) and cardiovascular mortality (OR 1.972, 95% CI 1.139 to 3.417, p = 0.015 ) after adjusting for confounders. Conclusions. Predialysis serum albumin, high-sensitivity C-reactive protein, ferritin, and creatinine were independent correlated factors of EPO responsiveness among maintenance hemodialysis patients. Patients with higher ERI values had a higher all-cause mortality rate and cardiovascular mortality rate.

scholarly journals Association between 4-year all-cause mortality and carnitine profile in maintenance hemodialysis patients

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0201591 ◽  
Author(s):  
Yuiko Kamei ◽  
Daigo Kamei ◽  
Ken Tsuchiya ◽  
Michio Mineshima ◽  
Kosaku Nitta
Keyword(s):  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
All Cause Mortality ◽  
Maintenance Hemodialysis Patients

scholarly journals MP406CHANGE IN PHYSICAL ACTIVITY AND RISK OF ALL-CAUSE MORTALITY IN MAINTENANCE HEMODIALYSIS PATIENTS

2016 ◽  
Vol 31 (suppl_1) ◽  
pp. i475-i475
Author(s):  
Takahiro Shimoda ◽  
Atsuhiko Matsunaga ◽  
Ryota Matsuzawa ◽  
Yoshifumi Abe ◽  
Kei Yoneki ◽  
...  
Keyword(s):  
Physical Activity ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
All Cause Mortality ◽  
Maintenance Hemodialysis Patients
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