Could albumin level explain the higher mortality in hemodialysis patients with pulmonary hypertension?

dc.contributorUniversidade Estadual Paulista (UNESP)
dc.creatorYoo, Hugo Hyung Bok
dc.creatorMartin, Luis Cuadrado
dc.creatorKochi, Ana Claudia
dc.creatorRodrigues-Telini, Lidiane Silva
dc.creatorBarretti, Pasqual
dc.creatorCaramori, Jacqueline Socorro Costa Teixeira
dc.creatorMatsubara, Beatriz Bojikian
dc.creatorZannati-Bazan, Silméia Garcia
dc.creatorFranco, Roberto Jorge da Silva
dc.creatorQueluz, Thais Helena Abrahão Thomaz
dc.date2014-05-27T11:26:54Z
dc.date2016-10-25T18:37:44Z
dc.date2014-05-27T11:26:54Z
dc.date2016-10-25T18:37:44Z
dc.date2012-08-08
dc.date.accessioned2017-04-06T01:59:59Z
dc.date.available2017-04-06T01:59:59Z
dc.identifierBMC Nephrology, v. 13, n. 1, 2012.
dc.identifier1471-2369
dc.identifierhttp://hdl.handle.net/11449/73483
dc.identifierhttp://acervodigital.unesp.br/handle/11449/73483
dc.identifier10.1186/1471-2369-13-80
dc.identifier2-s2.0-84864510746.pdf
dc.identifier2-s2.0-84864510746
dc.identifierhttp://dx.doi.org/10.1186/1471-2369-13-80
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/894289
dc.descriptionBackground: The pathogenesis of pulmonary hypertension (PH) in hemodialysis is still unclear. The aim of thisstudy was to identify the risk factors associated with the presence of PH in chronic hemodialysis patients and toverify whether these factors might explain the highest mortality among them.Methods: We conducted a retrospective study of hemodialysis patients who started treatment from August 2001to October 2007 and were followed up until April 2011 in a Brazilian referral medical school. According to theresults of echocardiography examination, patients were allocated in two groups: those with PH and those withoutPH. Clinical parameters, site and type of vascular access, bioimpedance, and laboratorial findings were comparedbetween the groups and a logistic regression model was elaborated. Actuarial survival curves were constructed andhazard risk to death was evaluated by Cox regression analysis.Results: PH > 35 mmHg was found in 23 (30.6%) of the 75 patients studied. The groups differed in extracellularwater, ventricular thickness, left atrium diameter, and ventricular filling. In a univariate analysis, extracellular waterwas associated with PH (relative risk = 1.194; 95% CI of 1.006 1.416; p = 0.042); nevertheless, in a multiple model,only left atrium enlargement was independently associated with PH (relative risk =1.172; 95% CI of 1.010 1.359;p = 0.036). PH (hazard risk = 3.008; 95% CI of 1.285 7.043; p = 0.011) and age (hazard risk of 1.034 per year of age;95% CI of 1.000 7.068; p = 0.047) were significantly associated with mortality in a multiple Cox regression analysis.However, when albumin was taken in account the only statistically significant association was between albuminlevel and mortality (hazard risk = 0.342 per g/dL; 95% CI of 0.119 0.984; p = 0.047) while the presence of PH lost itsstatistical significance (p = 0.184). Mortality was higher in patients with PH (47.8% vs 25%) who also had astatistically worse survival after the sixth year of follow up.Conclusions: PH in hemodialysis patients is associated with parameters of volume overload that sheds light on itspathophysiology. Mortality is higher in hemodialysis patients with PH and the low albumin level can explain thisassociation.© 2012 Greenfield et al.; licensee BioMed Central Ltd.
dc.languageeng
dc.relationBMC Nephrology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectEnd-stage renal disease
dc.subjectHemodialysis
dc.subjectPrognostic
dc.subjectPulmonary hypertension
dc.subjectadult
dc.subjectaged
dc.subjectalbumin blood level
dc.subjectcorrelation analysis
dc.subjectechocardiography
dc.subjectextracellular fluid
dc.subjectfemale
dc.subjectfollow up
dc.subjecthazard assessment
dc.subjectheart left ventricle filling
dc.subjectheart size
dc.subjectheart ventricle hypertrophy
dc.subjectheart ventricle wall
dc.subjecthemodialysis patient
dc.subjecthuman
dc.subjecthypervolemia
dc.subjectlogistic regression analysis
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmortality
dc.subjectpathophysiology
dc.subjectprognosis
dc.subjectproportional hazards model
dc.subjectpulmonary hypertension
dc.subjectretrospective study
dc.subjectrisk assessment
dc.subjectrisk factor
dc.subjectsurvival rate
dc.subjectvascular access
dc.subjectBrazil
dc.subjectComorbidity
dc.subjectFemale
dc.subjectHumans
dc.subjectHypertension, Pulmonary
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPrevalence
dc.subjectRenal Dialysis
dc.subjectRenal Insufficiency, Chronic
dc.subjectRisk Assessment
dc.subjectSerum Albumin
dc.subjectSurvival Analysis
dc.subjectSurvival Rate
dc.titleCould albumin level explain the higher mortality in hemodialysis patients with pulmonary hypertension?
dc.typeOtro


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