|
|
|
| Predictive Value of Serum Bilirubin Level in Patients with Peritoneal Dialysis |
| AN Ling |
| Renal Medicine Department Qinghai People's Hospital Xining 810007, Qinghai |
|
|
|
|
Abstract 【Objective】To investigate the correlation between serum bilirubin level and mortality in peritoneal dialysis(PD) patients and analyze its predictive value for prognosis of PD patients. 【Methods】A total of 140 patients with maintenance PD in our hospital from May 30, 2015 to May 30, 2017 were selected for the study. The blood bilirubin level was measured at 6 months of dialysis. The baseline clinical data and laboratory results were recorded. The termination time of follow-up was May 30, 2019, and the end point of follow-up was all-cause death. The ROC curve were used to determine the best cut-off point of blood bilirubin. The correlation between blood bilirubin and death were revealed and its predictive value for mortality were analyzed. 【Results】The follow-up time was 6-42 months and the median follow-up time was 34 months. A total of 33 patients died. The average level of blood bilirubin was (5.3 ± 1.4) μmol/L. The area under the ROC curve (AUC) of blood bilirubin predicted all-cause mortality was 0.69 (p=0.012), the best cut-off point of blood bilirubin was 3.3 μmol/L, the sensitivity was 67.5%, and the specificity was 69.1%. There were 32 patients with bilirubin low value (<3.3 μmol/L) and 108 patients with high bilirubin group (≥3.3 μmol/L). The albumin, serum calcium and hemoglobin levels in the low bilirubin group were lower than those in the high bilirubin group (P<0.05). The cumulative survival rate of low bilirubin group was lower than that of the high bilirubin group(P<0.05) . Uric acid, blood glucose, dialysis adequacy, age, and bilirubin were independent risk factors for all-cause mortality in maintenance PD patients (P<0.05). 【Conclusion】The mortality of maintenance PD with blood bilirubin <3.3 μmol/L is high. The blood bilirubin level is an effective biomarker for predicting all-cause death in patients with PD.
|
|
Received: 29 August 2019
|
|
|
|
|
|
[1] Liu X, Guo Q, Feng X, et al. Alkaline phosphatase and mortality in patients on peritoneal dialysis[J].Clin J Am Soc Nephrol,2014,9(4):771-778.
[2] Mortada I. Hyperbilirubinemia, Hypertension, and CKD: the Links[J].Curr Hypertens Rep,2017,19(7):58.
[3] Sakoh T, Nakayama M, Tanaka S, et al. Association of serum total bilirubin with renal outcome in Japanese patients with stages 3-5 chronic kidney disease[J].Metabolism,2015,64(9):1096-1102.
[4] 张启龙,王俊倪,王耀敏, 等.维持性腹膜透析患者血清尿酸水平对全因死亡及心血管事件死亡的影响[J].中华肾脏病杂志,2018,34(11):809-815.
[5] Liu CT, Lin YC, Lin YC, et al. Roles of serum calcium, phosphorus, PTH and ALP on mortality in peritoneal dialysis patients: a nationwide, population-based longitudinal study using TWRDS 2005-2012[J].Sci Rep,2017,7(1):33.
[6] Tanaka M, Fukui M, Okada H, et al. Low serum bilirubin concentration is a predictor of chronic kidney disease[J].Atherosclerosis,2014,234(2):421-425.
[7] Tanaka S, Ninomiya T, Masutani K, et al. Prognostic impact of serum bilirubin level on long-term renal survival in IgA nephropathy[J].Clin Exp Nephrol,2015,19(6):1062-1070.
[8] Su H H, Kao C M, Lin Y C, et al. Relationship between serum total bilirubin levels and mortality in uremia patients undergoing long-term hemodialysis: A nationwide cohort study[J].Atherosclerosis,2017,265:155-161.
[9] 范瑾瑾,刘新辉,易春燕, 等.低血清总胆红素水平与腹膜透析患者全因死亡与心血管事件死亡的相关性[J].中华肾脏病杂志,2018,34(11):801-808.
[10] Yang TL, Lin YC, Lin YC, et al. Total Bilirubin in Prognosis for Mortality in End-Stage Renal Disease Patients on Peritoneal Dialysis Therapy[J].J Am Heart Assoc,2017,6(12):e007507.
|
|
|
|
2020, Vol. 37 
