Renal amyloidosis is associated with increased mortality in hemodialysis patients.
OBJECTIVE
The aim of the study was to investigate the risk factors for mortality of hemodialysis (HD) patients at Baskent University Hospital, HD Center in Ankara, Turkey.


METHODS
We prospectively followed 203 stable HD patients for 42 months. Population characteristics (age, gender, duration of HD, causes of end stage renal disease [ESRD]) and biochemical variables were included in the study. Mortality was prospectively monitored.


RESULTS
Sixty-one patients died over 42 months. Cardiovascular events and infections/septicemia were the most common causes of death. The nonsurvivors had significantly lower hemoglobin (Hb), parathyroid hormone (PTH), creatinine, albumin, and prealbumin levels and higher age and higher C-reactive protein (CRP) levels. Survival curves as obtained by the Kaplan-Meier method in the groups of causes of ESRD (renal amyloidosis [RA], diabetes mellitus [DM], hypertension [HT] + atherosclerotic kidney disease [AKD], and others) showed that patients with DM and RA had the worst prognosis during the follow-up period. In the multivariate Cox proportional hazards model, RA and DM were found to be independent risk factors for death in HD patients together with high CRP and low albumin and prealbumin levels. Infection/septicemia is the leading cause of mortality in patients with DM and RA.


CONCLUSIONS
The results of this study indicate that the presence of RA and DM as underlying renal diseases are independent predictors of mortality in our HD patients along with poor nutritional status and activated inflammatory response.
Ankara University School of Medicine, Ibni Sina Hospital, Department of Nephrology, Ankara, Turkey. sengul@medicine.ankara.edu.tr
Sule
S
Sengul
Zubeyde
Z
Arat
F Nurhan
FN
Ozdemir
D000328:Adult; D000686:Amyloidosis / Q000150:complications* / Q000401:mortality*; D002423:Cause of Death; D048909:Diabetes Complications / Q000401:mortality; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D012307:Risk Factors