OBJECTIVES: To determine the significance of single values of certain biochemical and nutritional parameters as markers of mortality in patients undergoing dialytic therapy and to determine the influence of age, diabetes, treatment duration and nature of renal disease in patients outcome.
STUDY DESIGN: Retrospective
SETTING: St. Luke's Medical Center (SLMC)
SUBJECTS: Patients admitted at SLMC who underwent dialytic therapy from January 1993 to September 1994.
RESULTS: Sixty-eight subjects were included: Thirty-three underwent Intermittent Peritoneal Dialysis (IPD); fourteen, Continuous Ambulatory Peritoneal Dialysis (CAPD); and twenty-one, hemodialysis. In the IPD group, BUN was a significant determinant of mortality with a p=0.0326 while age, creatinine, total protein, albumin and cholesterol were not significant determinants of mortality. Diabetes nor the nature of the renal disease did not influence the patients outcome. In the CAPD group, only peritonitis was significant to patients outcome (p=0.001). In the hemodialysis group, age was a significant determinant of outcome (p=0.0156) while no association was found between survival or mortality and serum BUN, albumin, creatinine, total protein, cholesterol, duration of hemodialysis, its frequency per week, duration of session in hours, diabetes nor the nature of the renal disease.
CONCLUSION: Single level determination of BUN but not of albumin, cholesterol, and creatinine may be a potential predictor or mortality in dialysis patients. Peritonitis can be a marker of both morbidity and mortality in patients undergoing chronic peritoneal dialysis. Overall, age per se may not be a significant predictor of mortality while diabetes, treatment duration, and nature of renal disease were not correlated to patients mortality or survival. Furthermore, a more relevant study outcome can be obtained with a larger patient population with close and long term follow-up.