Early albumin level and mortality in hemodialysis patients: a retrospective study.

BACKGROUND: Hypoalbuminemia is a significant risk factor of cardiovascular disease and all-cause death in patients undergoing conventional hemodialysis (HD). However, the albumin (ALB) level of these dialysis patients runs through the whole process of dialysis, and the prognostic value of serum ALB in the early stage of HD and the relationship between the early ALB value and death in HD patients has not been reported. METHODS: The data of 447 patients with HD were retrospectively analyzed. The patients were stratified into three ALB (g/L) groups: low, ALB ≤34.2; moderate, 34.3< ALB <40.1; high, ALB ≥40.2. Survival trends of the three groups were analyzed by the Kaplan-Meier method. RESULTS: Comparison of the clinical data among the three groups showed a positive correlation between Hb, RBC, K+, Ca2+, Mg2+, and PHOS (P<0.05), but a negative correlation between age and high-sensitivity C-reactive protein (hsCRP) (P<0.05). The ALB level in early HD patients was an independent predictor of death [hazard ratio (HR) =0.945; 95% confidence interval (CI): 0.916-0.976; P=0.000], while age and hsCRP were protective factors (HR =1.048, 95% CI: 1.028-1.067, P=0.000; HR =1.049, 95% CI: 1.024-1.075, P=0.000). The estimated median overall survival (OS) at early HD was 56.00 months in the low ALB group, 83.00 months in the moderate ABL group, and 95.00 months in the high ALB group. The Kaplan-Meier estimate of survival showed a significant difference in OS among the three groups (log-rank P=0.000). CONCLUSIONS: The early ALB level not only reflects the nutritional and chronic inflammation status of HD patients, but can also predict the prognosis, which has guiding significance for the management of HD patients.

A novel lateral flow assay based on GoldMag nanoparticles and its clinical applications for genotyping of MTHFR C677T polymorphisms.

Current techniques for single nucleotide polymorphism (SNP) detection require tedious experimental procedures and expensive and sophisticated instruments. In this study, a visual genotyping method has been successfully established via combining ARMS-PCR with gold magnetic nanoparticle (GoldMag)-based lateral flow assay (LFA) and applied to the genotyping of methylenetetrahydrofolate reductase (MTHFR) C677T. C677T substitution of the gene MTHFR leads to an increased risk of diseases. The genotyping result is easily achievable by visual observation within 5 minutes after loading of the PCR products onto the LFA device. The system is able to accurately assess a broad detection range of initial starting genomic DNA amounts from 5 ng to 1200 ng per test sample. The limit of detection reaches 5 ng. Furthermore, our PCR-LFA system was applied to clinical trials for screening 1721 individuals for the C677T genotypes. The concordance rate of the genotyping results detected by PCR-LFA was up to 99.6% when compared with the sequencing results. Collectively, our PCR-LFA has been proven to be rapid, accurate, sensitive, and inexpensive. This new method is highly applicable for C677T SNP screening in laboratories and clinical practices. More promisingly, it could also be extended to the detection of SNPs of other genes.