Comparison of Serum Albumin, Serum C-Reactive Protein, and Pulse Wave Velocity as Predictors of the 4-Year Mortality of Chronic Hemodialysis Patients

Abstract

Aim:Although serum albumin and C-reactive protein (CRP) levels and pulse wave velocity (PWV) are known to be associated with the clinical outcome of hemodialysis (HD) patients, it is unknown which of these parameters are more predictive of the long-term mortality of such patients. Methods: We measured biochemical parameters, including serum albumin and CRP, and the PWV of 202 patients on maintenance HD therapy and followed their course for 4 years, and 186 of the patients were enrolled in the current study analyses. We divided the 186 patients into three tertiles according to their serum albumin and CRP levels and PWV values, and conducted multivariate analyses to examine the impact of the tertiles on 4-year mortality. Results: Twenty-three (12.4%) patients died during the follow-up period, and the serum albumin of the group that died was significantly lower than in the group that survived, but the CRP levels and PWV were significantly higher in the group that died. The results of Kaplan-Meier analyses revealed a significantly higher risk of all-cause mortality in HD patients with higher CRP based on the results of Cox proportional hazards analyses; however, the serum albumin and PWV values were not associated with all-cause mortality. Conclusion:The results of this study suggest that serum CRP levels are a better mortality predictor than serum albumin or PWV values of chronic HD patients.

Risk Factors for New-Onset Cardiac Valve Calcification in Patients on Maintenance Peritoneal Dialysis

“…Moreover, clinical and laboratory studies have shown that CRP can reduce serum Alb levels, activate the complement system and stimulate peripheral blood mononuclear cells to synthesize a membrane glycoprotein that activates the clotting response to promote cardiovascular damage [24]. Reduced serum Alb levels may reflect more serious atherosclerosis resulting from the uremic state, other nutrient deficiencies (e.g., folic acid and vitamin B 12 deficiencies cause an increase in homocysteine levels, a risk factor for atherosclerotic heart disease) or the inflammatory state [25] and promote endothelial injury [26]. …”

Brachial-Ankle PWV: Current Status and Future Directions as a Useful Marker in the Management of Cardiovascular Disease and/or Cardiovascular Risk Factors

“…Thirty articles examining the prognostic value of brachial-ankle PWV in prospective studies were identified 63, (Table 3). Of these, four studies examined the prognosis twice in the same cohorts [95][96][97][98] , and only one aggregate data meta-analysis is available to examine the usefulness of brachial-ankle PWV as a predictor of future cardiovascular events 99) . Age is an important determinant of arterial stiffness; therefore, PWV may be considered as a marker of aging, serving as an overall marker of death.…”

Brachial-Ankle Pulse Wave Velocity as a Predictor of Mortality in Elderly Chinese

“…[17][18][19][20][21][22][23][24][25] Nonetheless, brachial-ankle PWV measures stiffness of mixed elastic with muscular arteries, 26 instead of the elastic aorta alone, and hence quantitatively differs from carotid-femoral PWV and may have distinct values of cardiovascular prediction. In the present study, we investigated the predictive value of brachial-ankle PWV for mortality in an elderly Chinese population.…”

“…11 Previous studies have shown that brachial-ankle PWV is closely correlated with carotid-femoral PWV 12 and is also predictive of cardiovascular events and mortality in the general population [13][14][15][16] and in various patient cohorts. [17][18][19][20][21][22][23][24][25] Nonetheless, brachial-ankle PWV measures stiffness of mixed elastic with muscular arteries, 26 instead of the elastic aorta alone, and hence quantitatively differs from carotid-femoral PWV and may have distinct values of cardiovascular prediction. In the present study, we investigated the predictive value of brachial-ankle PWV for mortality in an elderly Chinese population.…”