title: Relation between serum estradiol levels and mortality in postmenopausal female hemodialysis patients.
abstract: BACKGROUND
  Recently, low serum estradiol levels have been associated with increased cardiovascular risk and mortality in non-uremic patient populations. We investigated the predictive value of serum estradiol levels for mortality in female hemodialysis patients.
  
  
  METHODS
  One hundred and forty-seven prevalent female hemodialysis patients were included in March 2005 and followed up for 32 ± 16 months. Serum estradiol levels were determined by ELISA at baseline and studied in relation to cardiovascular and overall mortality.
  
  
  RESULTS
  Mean serum estradiol level was 28.6 ± 15.4 pg/ml (5.7-81.3). Patients in the higher estradiol tertile were likely to be more often diabetic and to have more cardiovascular diseases and higher body mass index (BMI). Serum estradiol was inversely correlated with age and urea reduction rate and positively correlated with postdialysis body weight, BMI and hs-CRP levels. During the follow-up period, 52 (35.6 %) patients died. Patients who died were older, had shorter dialysis vintage, were more likely to have a history of diabetes and cardiovascular disease, and lower serum creatinine, albumin, hemoglobin, and higher hs-CRP levels than those who survived. In Cox regression analysis, estradiol levels, in a bimodal (U-shaped) distribution, along with diabetes, low serum albumin and high hs-CRP levels, were predictors for overall mortality.
  
  
  CONCLUSIONS
  A U-shaped association between serum estradiol levels and cardiovascular and overall mortality was found in postmenopausal hemodialysis patients.
authors.affiliation: Division of Nephrology, Izmir Tepecik Research and Training Hospital, Izmir, Turkey. mehmettanrisev@gmail.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tanrisev
authors.forename: Gulay
authors.initials: G
authors.lastname: Asci
authors.forename: Ozkan
authors.initials: O
authors.lastname: Gungor
authors.forename: Fatih
authors.initials: F
authors.lastname: Kircelli
authors.forename: Ebru
authors.initials: E
authors.lastname: Sevinc Ok
authors.forename: Mumtaz
authors.initials: M
authors.lastname: Yilmaz
authors.forename: Osman Z
authors.initials: OZ
authors.lastname: Sahin
authors.forename: Kezban Pinar
authors.initials: KP
authors.lastname: Ozen
authors.forename: Gultekin
authors.initials: G
authors.lastname: Suleymanlar
authors.forename: Huseyin
authors.initials: H
authors.lastname: Toz
authors.forename: Ercan
authors.initials: E
authors.lastname: Ok
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality*; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011237:Predictive Value of Tests; D011446:Prospective Studies; D006435:Renal Dialysis
chemical_list: D004958:Estradiol