A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort Study
Uremic toxins (UTs) generally accumulate in patients developing end-stage renal disease (ESRD). Although some kinds of UTs cause early death after starting hemodialysis (HD), it remains unknown whether the degree of excessive accumulation of various UTs is associated with worsening of prognosis. We...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-10-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/12/10/634 |
| _version_ | 1797552085390065664 |
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| author | Yohei Arai Shingo Shioji Hiroyuki Tanaka Daisuke Katagiri Fumihiko Hinoshita |
| author_facet | Yohei Arai Shingo Shioji Hiroyuki Tanaka Daisuke Katagiri Fumihiko Hinoshita |
| author_sort | Yohei Arai |
| collection | DOAJ |
| description | Uremic toxins (UTs) generally accumulate in patients developing end-stage renal disease (ESRD). Although some kinds of UTs cause early death after starting hemodialysis (HD), it remains unknown whether the degree of excessive accumulation of various UTs is associated with worsening of prognosis. We retrospectively conducted this cohort study consisting of adult patients developing ESRD who initiated HD at the National Center for Global Health and Medicine from 2010 to 2019. We created a new uremic score, which was defined as the aggregate score of the following variables reflecting uremic state: elevated blood urea nitrogen, β2-microglobulin, and anion gap before starting HD. The primary outcome was early mortality within 1-year after HD commencement. The hazard ratio (HR) and 95% confidence interval (CI) for a one-point increase in uremic score was calculated with Cox proportional hazard models adjusted by baseline conditions. We included 230 participants, 16 of whom experienced the primary outcome of early mortality after HD commencement. Uremic score was significantly associated with the primary outcome (crude HR: 1.91, 95% CI 1.16–3.14; adjusted HR: 4.19, 95% CI 1.79–9.78). Our novel uremic score, reflecting accumulation of specific UTs, more precisely predicts early mortality after HD commencement. |
| first_indexed | 2024-03-10T15:54:56Z |
| format | Article |
| id | doaj.art-5e3d31e52afd46b992c9fb907f5e2d3f |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-10T15:54:56Z |
| publishDate | 2020-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-5e3d31e52afd46b992c9fb907f5e2d3f2023-11-20T15:47:02ZengMDPI AGToxins2072-66512020-10-01121063410.3390/toxins12100634A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort StudyYohei Arai0Shingo Shioji1Hiroyuki Tanaka2Daisuke Katagiri3Fumihiko Hinoshita4Department of Nephrology, National Center for Global Health and Medicine, Tokyo 162-8655, JapanDepartment of Nephrology, Yokosuka Kyosai Hospital, Kanagawa 238-8558, JapanDepartment of Nephrology, Yokosuka Kyosai Hospital, Kanagawa 238-8558, JapanDepartment of Nephrology, National Center for Global Health and Medicine, Tokyo 162-8655, JapanDepartment of Nephrology, National Center for Global Health and Medicine, Tokyo 162-8655, JapanUremic toxins (UTs) generally accumulate in patients developing end-stage renal disease (ESRD). Although some kinds of UTs cause early death after starting hemodialysis (HD), it remains unknown whether the degree of excessive accumulation of various UTs is associated with worsening of prognosis. We retrospectively conducted this cohort study consisting of adult patients developing ESRD who initiated HD at the National Center for Global Health and Medicine from 2010 to 2019. We created a new uremic score, which was defined as the aggregate score of the following variables reflecting uremic state: elevated blood urea nitrogen, β2-microglobulin, and anion gap before starting HD. The primary outcome was early mortality within 1-year after HD commencement. The hazard ratio (HR) and 95% confidence interval (CI) for a one-point increase in uremic score was calculated with Cox proportional hazard models adjusted by baseline conditions. We included 230 participants, 16 of whom experienced the primary outcome of early mortality after HD commencement. Uremic score was significantly associated with the primary outcome (crude HR: 1.91, 95% CI 1.16–3.14; adjusted HR: 4.19, 95% CI 1.79–9.78). Our novel uremic score, reflecting accumulation of specific UTs, more precisely predicts early mortality after HD commencement.https://www.mdpi.com/2072-6651/12/10/634end stage renal diseaseuremic toxinsmortalityhemodialysis |
| spellingShingle | Yohei Arai Shingo Shioji Hiroyuki Tanaka Daisuke Katagiri Fumihiko Hinoshita A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort Study Toxins end stage renal disease uremic toxins mortality hemodialysis |
| title | A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort Study |
| title_full | A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort Study |
| title_fullStr | A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort Study |
| title_full_unstemmed | A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort Study |
| title_short | A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort Study |
| title_sort | novel uremic score reflecting accumulation of specific uremic toxins more precisely predicts one year mortality after hemodialysis commencement a retrospective cohort study |
| topic | end stage renal disease uremic toxins mortality hemodialysis |
| url | https://www.mdpi.com/2072-6651/12/10/634 |
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