Mortality and low serum bicarbonate level in patients on hemodiafiltration versus peritoneal dialysis

In this study, we observed the mortality rate in relation to risk factors including low serum bicarbonate level, coronary artery disease (CAD), and dialysis modality in patients on dialysis during a median follow-up time of 60 months. We studied 96 dialysis patients, 62 males and 34 females, on mean age 62.1 &#177; 14.27 years old. The treatment modalities which were applied were predilution hemodiafiltration (HDF, n &#61; 76), and peritoneal dialysis (PD, n &#61; 20). We performed Kaplan&#8211;Meier curves and a Cox-regression analysis to investigate significant risk factors for mortality including hypertension, diabetes mellitus, smoking, bone disease defined by intact-parathormone, serum albumin, serum bicarbonate levels < or >22 mEq/L, dialysis modality, and the existence of CAD. Cox-regression analysis revealed a significant impact of serum bicarbonate levels &#60;22 mEq/L on mortality in combination to dialysis modality and CAD. The prevalence of CAD on mortality was found significant (log-rank &#61; 5.507, P &#61; 0.02). Furthermore, the impact of dialysis modality on mortality was shown significant (log rank &#61; 22.4, P &#61; 0.001), noting that during the first 28&#8211;30 months from the treatment initiation, the survival was better for PD; but then, the mortality was significantly increased comparatively to HDF. Uncorrected metabolic acidosis and CAD were shown as independent significant ...
Source: Indian Journal of Nephrology - Category: Urology & Nephrology Authors: Source Type: research