The impact of high serum bicarbonate levels on mortality in hemodialysis patients
The Korean Journal of Internal Medicine
; : 109-116, 2017.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-49982
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND/AIMS:
The optimal serum bicarbonate level is controversial for patients who are undergoing hemodialysis (HD). In this study, we analyzed the impact of serum bicarbonate levels on mortality among HD patients.METHODS:
Prevalent HD patients were selected from the Clinical Research Center registry for End Stage Renal Disease cohort in Korea. Patients were categorized into quartiles according to their total carbon dioxide (tCO₂) levels quartile 1, a tCO₂ of < 19.4 mEq/L; quartile 2, a tCO₂ of 19.4 to 21.5 mEq/L; quartile 3, a tCO₂ of 21.6 to 23.9 mEq/L; and quartile 4, a tCO₂ of ≥ 24 mEq/L. Cox regression analysis was used to calculate the adjusted hazard ratio (HR) and confidence interval (CI) for mortality.RESULTS:
We included 1,159 prevalent HD patients, with a median follow-up period of 37 months. Kaplan-Meier analysis revealed that the all-cause mortality was significantly higher in patients from quartile 4, compared to those from the other quartiles (p = 0.009, log-rank test). The multivariate Cox proportional hazard model revealed that patients from quartile 4 had significantly higher risk of mortality than those from quartile 1, 2 and 3, after adjusting for the clinical variables in model 1 (HR, 1.99; 95% CI, 1.15 to 3.45; p = 0.01) and model 2 (HR, 1.82; 95% CI, 1.03 to 3.22; p = 0.04).CONCLUSIONS:
Our data indicate that high serum bicarbonate levels (a tCO₂ of ≥ 24 mEq/L) were associated with increased mortality among prevalent HD patients. Further effort might be necessary in finding the cause and correcting metabolic alkalosis in the chronic HD patients with high serum bicarbonate levels.
Texto completo:
Disponível
Contexto em Saúde:
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
Problema de saúde:
Doença Renal Crônica
/
Doenças do Sistema Endócrino
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Bicarbonatos
/
Dióxido de Carbono
/
Modelos de Riscos Proporcionais
/
Estudos de Coortes
/
Seguimentos
/
Mortalidade
/
Diálise Renal
/
Alcalose
/
Estimativa de Kaplan-Meier
/
Falência Renal Crônica
Tipo de estudo:
Estudo de etiologia
/
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
The Korean Journal of Internal Medicine
Ano de publicação:
2017
Tipo de documento:
Artigo