[Renal disease severity index, clinical indicators and mortality of patients in hemodialysis].
OBJECTIVE
Comorbidity is a major factor influencing mortality in hemodialysis patients. Kt/V, hematocrit and albumin levels have also been associated with mortality in these patients. The purpose of this study was to evaluate the severity of comorbidity, Kt/V, hematocrit and albumin levels as predictors of mortality in patients on hemodialysis therapy.


METHODS
Forty patients were followed up during 12 months and assessed in relation to social demographic characteristics, time on dialysis therapy, presence of diabetes, Kt/V, hematocrit and albumin levels, also comorbidities. The impact of comorbidity on mortality was assessed by the end-stage renal disease severity index (ESRD-SI).


RESULTS
Mean ESRD-SI scores for survivals (85%) and deaths (15%) were 22 +/- 14.8 vs. 44 +/- 12.4 (p < 0.001), and for diabetic (29%) and non-diabetic patients (71%), 40 +/- 15.1 vs. 19 +/- 12.5 (p < 0.001). An inverse correlation was observed between ESRD-SI scores and albumin (r = -0.475; p < 0.005). Albumin levels = 3.6 g/dL were mostly observed (82%) in patients without diabetes (p = 0.021). A correlation was observed between hematocrit and albumin levels (r = 0.544; p < 0.001). For each 1-point increase in the ESRD-SI scores, there was a 10% increase in the risk of death (p = 0.0093).


CONCLUSIONS
The ESRD-SI is useful to assess the severity of comorbidities and to predict mortality in hemodialysis patients.
Morsch
Cássia
C
Serviço de Nefrologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, RS.
Gonçalves
Luiz Felipe
LF
Barros
Elvino
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D015897:Comorbidity; D004812:Epidemiologic Methods; D005260:Female; D006400:Hematocrit; D006801:Humans; D007676:Kidney Failure, Chronic / Q000145:classification / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000401:mortality*; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index; D012959:Socioeconomic Factors
D015415:Biomarkers; D012709:Serum Albumin