Associations of low serum total bilirubin level with all?cause mortality and cardiovascular mortality in peritoneal dialysis patients
10.3760/cma.j.issn.1001?7097.2018.11.001
- VernacularTitle: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
- Author:
Jinjin FAN
1
;
Xinhui LIU
;
Chunyan YI
;
Jianxiong LIN
;
Xiao YANG
;
Xueqing YU
Author Information
1. 中山大学附属第一医院肾内科 卫健委重点实验室
- Keywords:
Peritoneal dialysis;
Bilirubin;
Mortality;
Cardiovascular mortality
- From:
Chinese Journal of Nephrology
2018;34(11):801-808
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the association of low serum total bilirubin (TBIL) levelwith all?cause mortality and cardiovascular mortality in peritoneal dialysis patients. Methods As a single ? center, retrospective, cohort study, all the patients who underwent peritoneal dialysis catheterization in the Department of Nephrology, the First Affiliated Hospital of Sun Yat?sen University and started peritoneal dialysis for more than 3 months from January 1, 2006 to December 31, 2010 were included. Demographics, baseline clinical and laboratory test results were collected. All patients were followed up until December 31, 2012. Patients were divided into 4 groups according to their baseline serum TBIL levels (interquartile range). Kaplan?Meier method was used to compare the survival rate of each group. Cox regression model was used to analyze the association of TBIL with all?cause mortality and cardiovascular mortality. Logistic regression was used to analyze the influencing factors of low TBIL level. Results A total of 880 peritoneal dialysis patients with baseline TBIL data were enrolled in this study, with age of (48.0 ± 15.4) years old, among whom 59.0％ were male. Median TBIL was 4.5 μmol/L and interquartile range was 3.4?5.8 μmol/L. The comparison between TBIL quartile groups showed that the difference in proportion of diabetics, Charlson comorbidity index, hemoglobin, serum albumin, serum calcium, intact parathyroid hormone, urea nitrogen, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was statistically significant (all P<0.05), while the difference in body mass index (BMI), estimated glomerular filtration rate, serum creatinine, urea nitrogen, uric acid and phosphorus was not statistically significant. After a median follow?up of 31 months, 194 patients died, 104 of which were cardiovascular deaths. Kaplan?Meier curves showed higher all?cause mortality in patients with TBIL≤3.4 μmol/L (Q1 group) (P=0.032) and there was no statistical difference in the cardiovascular mortality among different groups. After adjusting for biochemical indicators such as demographics, comorbidities, and liver function, taking baseline TBIL Q2 level (3.4
