title: Low plasma DHEA-S increases mortality risk among male hemodialysis patients.
abstract: OBJECTIVE
  The incidence of chronic kidney disease (CKD) is on the rise. CKD patients are at high risk of cardiovascular (CVD) and all-cause mortality. CKD patients have several endocrine disorders, including low levels of dehydroepiandrosterone sulfate (DHEA-S). In the general population, low levels of DHEA-S are associated with high CVD and all-cause mortality. The aim of this study was to analyze the prognostic value of plasma DHEA-S on the survival of CKD patients on hemodialysis.
  
  
  METHODS
  This was a single-center prospective cohort study on two hundred CKD patients on hemodialysis, which assessed the prognostic value of plasma DHEA-S on their survival.
  
  
  RESULTS
  We found that plasma DHEA-S levels were negatively associated with age, and positively associated with dialysis duration and plasma creatinine, albumin, and phosphate levels in hemodialysis men. Elderly patients with co-morbidities (i.e. diabetes mellitus, congestive heart failure, and chronic obstructive pulmonary disease), poorer fluid control which was evaluated by higher cardiothoracic ratio, and low plasma creatinine and albumin levels seemed to have poor prognosis in hemodialysis men. Furthermore, low plasma DHEA-S levels were significantly associated with CVD-related [hazard ratio (HR)=3.877; P=0.021], non-CVD-related (HR=3.522; P=0.016), and all-cause mortality (HR=3.667; P=0.001) in hemodialysis men. But low plasma DHEA-S levels were not significantly associated with CVD-related, non-CVD-related, and all-cause mortality in hemodialysis women. Multivariate Cox regression analysis suggested that low plasma DHEA-S levels are significantly and independently associated with all-cause mortality in hemodialysis men (HR=2.933; P=0.033).
  
  
  CONCLUSIONS
  The study suggested that low plasma DHEA-S was independently and significantly associated with all-cause mortality in CKD hemodialysis men.
authors.affiliation: Division of Nephrology, Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Heng-Jung
authors.initials: HJ
authors.lastname: Hsu
authors.forename: Chiung-Hui
authors.initials: CH
authors.lastname: Yen
authors.forename: Chih-Ken
authors.initials: CK
authors.lastname: Chen
authors.forename: Kuang-Hung
authors.initials: KH
authors.lastname: Hsu
authors.forename: Cheng-Cheng
authors.initials: CC
authors.lastname: Hsiao
authors.forename: Chin-Chan
authors.initials: CC
authors.lastname: Lee
authors.forename: I-Wen
authors.initials: IW
authors.lastname: Wu
authors.forename: Chiao-Yin
authors.initials: CY
authors.lastname: Sun
authors.forename: Chia-Chi
authors.initials: CC
authors.lastname: Chou
authors.forename: Ming-Fang
authors.initials: MF
authors.lastname: Hsieh
authors.forename: Chun-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Chiao-Ying
authors.initials: CY
authors.lastname: Hsu
authors.forename: Chi-Jen
authors.initials: CJ
authors.lastname: Tsai
authors.forename: Mai-Szu
authors.initials: MS
authors.lastname: Wu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D012737:Sex Factors; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D019314:Dehydroepiandrosterone Sulfate