The relative contribution of measured variables to death risk among hemodialysis patients

Reassessment of Albumin as a Nutritional Marker in Kidney Disease

“…The association was first described in 1990, when a serum albumin Ͻ4 g/dl was found to be inversely and progressively associated with increased risk for death in hemodialysis patients. 55 Three years later, Owen et al 56 confirmed this observation. Although similar findings have subsequently been described in various populations with CKD, the relationship is highly unlikely to be causal, because even individuals who are born with a complete absence of circulating albumin (analbuminemia) manifest only minimal, if any, clinical symptoms.…”

Illustrating Use of a Clinical Data System

“…Creatinine, urea reduction ratio (URR), albumin, and the anion gap accounted for nearly 70% of the model's predictive power. Earlier relationships (4) for albumin, creatinine, urea, and cholesterol were confirmed (9). Age, fraction of ideal weight, blood pressure, white blood count, and hematocrit were also important.…”

“…The first such report, using 1991 data, was sent to facilities and published (9). Figure 1 is a prioritization curve that focused attention on important measures.…”

“…Figure 1 is a prioritization curve that focused attention on important measures. The sequence of variables accumulates by strength of their associations with risk (9). Creatinine, urea reduction ratio (URR), albumin, and the anion gap accounted for nearly 70% of the model's predictive power.…”

Cardiovascular Morbidity in Hemodialysis: The Reverse Epidemiology Phenomenon

“…They examined whether BMI (calculated using 3-month averaged post-HD dry weight) and 3-month averaged serum creatinine levels and their changes over time were predictive of mortality risk. They assessed muscle mass by using serum creatinine measurements since in long-term HD patients who have minimal or no residual renal function and who undergo a stable HD treatment regimen, time-averaged serum creatinine concentration is a more likely surrogate of muscle mass, and its changes over time may represent parallel changes in skeletal muscle mass [31,32]. According to their findings higher BMI (up to 45) and higher serum creatinine concentration were incrementally and independently associated with greater survival, even after extensive multivariate adjustment for available surrogates of nutritional status and inflammation.…”