Predictors in mortality risk stratification in patients with chronic kidney disease on hemodialysis
Palabras clave:
End stage renal disease, Hemodialysis, Mortality, PredictorsResumen
Introduction: The identification of predictors of mortality in patients with chronic kidney disease on hemodialysis, which allows the identification of early treatment to patients at higher risk of death, it is necessary in practice current clinic.
Objective: To describe the predictors of mortality in patients with disease chronic kidney on hemodialysis.
Methods: A bibliographic review of the theoretical foundations on the Mortality risk stratification in patients with chronic kidney disease on hemodialysis. The resources available through Infomed (PubMed, PubMed Central, SciELO, Web of Science, Scopus, Ebsco, Clinical Key), as well as Google Scholar. The search strategies were: “chronic kidney disease OR renal insufficiency OR end-stage renal disease and hemodialysis and mortality and predictors OR predictive models”.
Development: Chronic kidney disease mortality risk stratification in hemodialysis is complex, taking into account that there are numerous traits that can influence the outcome end of patients. Multiple variables have an implication in the classification of the risk of the patient, which depend on the history, the clinical evolution of the disease, paraclinical results and adherence to hemodialysis.
Conclusions: The predictors in the risk stratification of Mortality in patients with chronic kidney disease on hemodialysis. These Predictors do not act in isolation, but rather interact with each other to influence the patient prognosis. The comprehensive and systematic evaluation, which integrates these variables can help personalize treatment and improve clinical outcomes.
Descargas
Citas
Bello A, Okpechi I, Osman M, Cho Y, Htay H, Jha V, et al. Epidemiology of hemodialysis outcomes. Nature Reviews Nephrology [Internet]. 2022 [access Feb 18 2023];18(1): 378-395. DOI: https://doi.org/10.1038/s41581-022-00542-7
Ríos Burrows N, Koyama A, Pavkov M. Reported Cases of End-Stage Kidney Disease — United States, 2000–2019. Morbidity and Mortality Weekly Report [Internet]. 2022 [access Feb 18 2023];71(11)1-15. DOI: https://doi.org/10.15585/mmwr.mm7111a3
Anuario Estadístico de Salud, 2023. Ministerio de Salud Pública. Dirección de Registros médicos y Estadísticas de salud. [Internet] La Habana, 2024 [access Feb 18 2023]. Disponible en: http://bvscuba.sld.cu/anuario-estadistico-de-cuba/
Singh V, Asari V, Rajasekaran R. A Deep Neural Network for Early Detection and Prediction of Chronic Kidney Disease. Diagnostics [Internet]. 2022 [access Feb 18 2023];12(1):116. DOI: https://doi.org/10.3390/diagnostics12010116
Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney International Supplements [Internet]. 2022 [access Feb 18 2023];12(1): 7–11. DOI: https://doi.org/10.1016/j.kisu.2021.11.003
Yip W, Hui S, Xiang N, Kaur P, George P, Guan J, et al. Risk factors for short-term all-cause mortality in patients with end stage renal disease: a scoping review. BMC Nephrology [Internet]. 2024 [access Feb 18 2023];25(1):71. DOI: https://doi.org/10.1186/s12882-024-03503-3
Mayrink Ivo JF, Sugizaki CS, Souza Freitas AT, Costa NA, Peixoto MR. Age, hemodialysis time, gait speed, but not mortality, are associated with muscle quality index in end-stage renal disease. Experimental Gerontology [Internet]. 2023 [access Feb 18 2023];171(1):112035. DOI: https://doi.org/10.1016/j.exger.2022.112035
Miao H, Liu L, Wang Y, Wang Y, He Q, Jafar TH, et al. Chronic kidney disease biomarkers and mortality among older adults: A comparison study of survey samples in China and the United States. PLoS ONE [Internet]. 2022 [access Feb 18 2023];17(1):e0260074. DOI: https://doi.org/10.1371/journal.pone.0260074
Meyer AM, Pickert L, Heeb A, Becker I, Kurschat C, Bartram M, et al. Prognostic Signature of Chronic Kidney Disease in Advanced Age: Secondary Analysis from the InGAH Study with One-Year Follow-Up. Biomolecules [Internet]. 2022 [access Feb 18 2023];12(1):423. DOI: https://doi.org/10.3390/biom12030423
González-Milán ZC, Escalona-González SO, Ramírez-Fernández A. Factores pronósticos de mortalidad en pacientes con insuficiencia renal crónica terminal en terapia hemodialítica. Revista Electrónica Dr. Zoilo E. Marinello Vidaurreta [Internet]. 2019 [access Feb 18 2023]; 44(6):1-15. Disponible en: http://revzoilomarinello.sld.cu/index.php/zmv/article/view/2041.
Khazaei S, Najafi-Ghobadi S, Ramezani-Doroh V. Construction data mining methods in the prediction of death in hemodialysis patients using support vector machine, neural network, logistic regression and decision tree. J Prev Med Hyg [Internet]. 2021 [access Feb 18 2023];62(1):E222E230. DOI: https://doi.org/10.15167/2421-4248/jpmh2021.62.1.1837
Astley M, Caskey FJ, Evans M, Torino C, Szymczak M, Drechsler C, et al. The impact of gender on the risk of cardiovascular events in older adults with advanced chronic kidney disease. Clinical Kidney Journal [Internet]. 2023 [access Feb 18 2023];16(12):2396-2404. DOI: https://doi.org/10.1093/ckj/sfad088
Jung J, Jeon‑Slaughter H, Nguyen H, Patel J, Sambandam K, Shastri S, et al. Hyperphosphatemia and its relationship with blood pressure, vasoconstriction, and endothelial cell dysfunction in hypertensive hemodialysis patients. BMC Nephrology [Internet]. 2022 [access Feb 18 2023];23(1):291. DOI: https://doi.org/10.1186/s12882-022-02918-0
Zhang Y, Li J, Wang A, Wang B, Shou-Liang Hu, Zhang H, et al. Effects of intensive blood pressure control on mortality and cardiorenal function in chronic kidney disease patients. Renal Failure [Internet]. 2021 [access Feb 18 2023];43(1):811-820. DOI: https://doi.org/10.1080/0886022X.2021.1920427
Yanai K, Ishibashi K, Morishita Y. Systematic review and meta-analysis of rennin-angiotensin-aldosterone system blocker effects on the development of cardiovascular disease in patients with chronic kidney disease. Front Pharmacol [Internet]. 2021 [access Feb 18 2023];12(1):662544. DOI: https://doi.org/10.3389/fphar.2021.662544
Tuttle K, Levin A, Nangaku M, Kadowaki T, Agarwal R, Hauske S, et al. Safety of Empagliflozin in Patients With Type 2 Diabetes and Chronic Kidney Disease: Pooled Analysis of Placebo Controlled Clinical Trials. Diabetes Care [Internet]. 2022 [access Feb 18 2023];45(1):1445–1452. DOI: https://doi.org/10.2337/dc21-2034
Rossing P, Burgess E, Agarwal R, Anker S, Filippatos G, Pitt B, et al. Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes According to Baseline HbA1c and Insulin Use: An Analysis From the FIDELIO-DKD Study. Diabetes Care [Internet]. 2022 [access Feb 18 2023];45(1):888–897. DOI: https://doi.org/10.2337/dc21-1944
Saputro S, Pattanaprateep O, Pattanateepapon A, Karmacharya S, Thakkinstian A. Prognostic models of diabetic microvascular complications: a systematic review and meta-analysis. Syst Rev [Internet]. 2021 [access Feb 18 2023];10(1):288. DOI: https://doi.org/10.1186/s13643-021-01841-z
Liu H, Wang R. Associations between the serum magnesium and all-cause or cardiovascular mortality in chronic kidney disease and end-stage renal disease patients. A meta-analysis. Medicine [Internet]. 2021 [access Feb 18 2023];100(1):45. DOI: http://dx.doi.org/10.1097/MD.0000000000027486
Yang L, Ye N, Bian W, Cheng H. Efficacy of medication therapy for patients with chronic kidney disease and heart failure with preserved ejection fraction: a systematic review and meta-analysis. International Urology and Nephrology [Internet]. 2022 [access Feb 18 2023];54(1):1435–1444. DOI: https://doi.org/10.1007/s11255-021-03025-z
Zhu H, Yin C, Schoepf J, Wang D, Zhou C, Lu GM, et al. Machine Learning for the Prevalence and Severity of Coronary Artery Calcification in Nondialysis Chronic Kidney Disease Patients A Chinese Large Cohort Study. J Thorac Imaging [Internet]. 2022 [access Feb 18 2023];37(1):401–408. DOI: https://doi.org/10.1097/RTI.0000000000000657
Wolff Gowdak LH, Galvao de Lima JJ, Leal Adam E, Kirnew Abud IC, Reusing JO, David-Neto E, et al. Coronary artery disease assessment and cardiovascular events in middle-aged patients on hemodialysis. Mayo Clinic Proceedings [Internet]. 2024 [access Feb 18 2023];99(3):411-423. DOI: https://doi.org/10.1016/j.mayocp.2023.05.007
Sakuma H, Ikeda M, Nakao S, Suetsugu R, Matsuki M, Hasebe N, et al. Regional variation in pre-dialysis blood pressure and its association with cardiovascular mortality rates in Japanese patients undergoing dialysis. Hypertension Research [Internet]. 2024 [access Feb 18 2023];47(1):102-111. DOI: https://doi.org/10.1038/s41440-023-01415-7
Wang J, Chen Z, Qiu Y, Wu L, Wang H, Wu L, et al. Statins Have an Anti-Inflammation in CKD Patients: A Meta-Analysis of Randomized Trials. BioMed Research International [Internet]. 2022 [access Feb 18 2023];4842699. DOI: https://doi.org/10.1155/2022/4842699
Sung FC, Jong YC, Muo CH, Hsu CC, Tsai WC, Hsu YH. Statin Therapy for Hyperlipidemic Patients with Chronic Kidney Disease and End-Stage Renal Disease: A Retrospective Cohort Study Based on 925,418 Adults in Taiwan. Front. Pharmacol [Internet]. 2022 [access Feb 18 2023];13(1):815882. DOI: https://doi.org/10.3389/fphar.2022.815882
Lee C, Park J, Chang T, Kang E, Nam K, Joo Y, et al. Low-density lipoprotein cholesterol levels and adverse clinical outcomes in chronic kidney disease: Results from the KNOW-CKD. Nutrition, Metabolism & Cardiovascular Diseases [Internet]. 2022 [access Feb 18 2023];32(1):410-419. DOI: https://doi.org/10.1016/j.numecd.2021.09.037
Yoon J, Han T, Heo SJ, Kwon YJ. Comprehensive assessment of the combined impact of dyslipidemia and inflammation on chronic kidney disease development: A prospective cohort study. Journal of Clinical Lipidology [Internet]. 2024 [access Feb 18 2023];In Press:1-23. DOI: https://doi.org/10.1016/j.jacl.2024.01.002
Kelly D, Ademi Z, Doehner G, Lip G, Mark P, Kazunori T, et al. Chronic kidney disease and cerebrovascular disease. Consensus and Guidance from a KDIGO Controversies Conference. Stroke [Internet]. 2021 [access Feb 18 2023];52(1):e328-e346. DOI: https://doi.org/10.1161/STROKEAHA.120.029680
Shinya Y, Miyawaki S, Kumagai I, Sugiyama T, Takenobu A, Saito N, et al. Risk factors and outcomes of cerebral stroke in end-stage renal disease patients receiving hemodialysis. Journal of Stroke and Cerebrovascular Diseases [Internet]. 2020 [access Feb 18 2023];29(4):104657. DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104657
Barrios C, Pascual J, Otero S, Soler MJ, Rodríguez E, Collado S, et al. Diabetic nephropathy is an independent factor associated to severe subclinical atheromatous disease. Atherosclerosis [Internet]. 2015 [access Feb 18 2023];242(1):37-44. DOI: https://doi.org/10.1016/j.atherosclerosis.2015.06.048
Yu-Huan S, Guang-Yan C, Yue-Fei X. Risk factors for intracerebral hemorrhage in patients undergoing maintenance hemodialysis. Front. Neurol [Internet]. 2023 [access Feb 18 2023];14(1):1-18. DOI: https://doi.org/10.3389/fneur.2023.1111865
Morimoto N, Urayama K, Ozawa K, Tanaka H. Utility of a modified controlling nutritional status score in mortality risk assessment of patients on hemodialysis. International Urology and Nephrology [Internet]. 2023 [access Feb 18 2023];55(5):1311-1320. DOI: https://doi.org/10.1007/s11255-022-03444-6
Yaparak B, Arslan N, Alatas H. Multiple factors influencing mortality in hemodialysis patients. European Review for Medical & Pharmacological Sciences [Internet]. 2023 [access Feb 18 2023];27(3):1095-1103. DOI: https://doi.org/10.26355/eurrev_202302_31212
Mudrik-Zohar H, Alon D, Nacasch N, Sternschuss A, Greenberg M, Benchetrit S, et al. Neutrophil reactive oxigen formation, bacterial infections and mortality in malnourished hemodialysis patients: Evaluation of clinical outcomes. Seminars in Dialysis [Internet]. 2023 [access Feb 18 2023];36(5):399-406. DOI: https://doi.org/10.1111/sdi.13168
Kim DW, Lee M, Lee KJ, Lee YH, Kim D, Shin SJ, et al. The combined clinical impact of red blood cell distribution width and vascular calcification on cardiovascular events and mortality in patients with end-stage kidney disease. Kidney Res Clin Pract [Internet]. 2022 [access Feb 18 2023];41(3):351-362. DOI: https://doi.org/10.23876/j.krcp.21.078
Wittbrodt E, James G, Kumar S, van Haalen H, Chen H, Sloand J, et al. Contemporary outcomes of anemia in US patients with chronic kidney disease. Clinical Kidney Journal [Internet]. 2022 [access Feb 18 2023];15(2):244–252. DOI: https://doi.org/10.1093/ckj/sfab195
Asmar J, Chelala D, Chejade RE, Azar H, Finianos S, Aoun M. Anemia biomarkers and mortality in hemodialysis patient with or without diabetes: A 10-year follow-up study. Plos One [Internet]. 2023 [access Feb 18 2023];18(1):e0280871. DOI: 10.1371/journal.pone.0280871
Morooka H, Tanaka A, Inaguma D, Maruyama S. Peripheral artery disease at the time of dialysis initiation and mortality: a prospective observational multicenter study. BMJ Open [Internet]. 2020 [access Feb 18 2023];10(12):e042315.DOI: https://doi.org/10.1136/bmjopen-2020-042315
Yang Y, Ning Y, Shang W. Association of peripheral arterial disease with all-cause and cardiovascular mortality in hemodialysis patients: a meta-analysis. BMC Nephrol [Internet]. 2016 [access Feb 18 2023];17(1):1-9. DOI: https://doi.org/10.1186/s12882-016-0397-1
Lin SC, Chou HH, Lin TY, Huang HL. Corrected QT interval and outcomes of dialysis patients with symptomatic peripheral artery disease: a prospective cohort study. Journal of Clinical Medicine [Internet]. 2024 [access Feb 18 2023];13(3):654. DOI: https://doi.org/10.3390/jcm13030654
Sugarawa K, Yamashita H, Yajima S, Oshima Y, Mitsumori N, Fujisaki M, et al. Prognosis of hemodialysis patients undergoing surgery for gastric cancer: Results of a multicenter retrospective study. Surgery [Internet]. 2021 [access Feb 18 2023];170(1):249-256. DOI: https://doi.org/10.1016/j.surg.2021.01.014
Chen X, Li Y, Ding X, Shen B, Xiang F, Guo M, et al. Incidence, risk, and prognosis of cancer in patients on chronic hemodialysis. Blood Purification [Internet]. 2020 [access Feb 18 2023];49(3):310-321. DOI: https://doi.org/10.1159/000504243
Lees JS, Elyan BM, Herrmann SM, Lang NN, Jones RJ, Mark PB. The other big complication: how chronic kidney disease impacts on cancer risks and outcomes. Nephrology Dialysis Transplantation [Internet]. 2023 [access Feb 18 2023];38(5):1071-1079. DOI: https://doi.org/10.1093/ndt/gfac011
Levey A, Grams M, Inker L. Uses of GFR and Albuminuria Level in Acute and Chronic Kidney Disease. N Engl J Med [Internet]. 2022 [access Feb 18 2023];386(1):2120-8. DOI: https://doi.org/10.1056/NEJMra2201153
Lv L, Chen X, Hu J, Wu J, Luo W, Shen Y, et al. Effect of Glomerular Filtration Rate by Different Equations on Prediction Models for End-Stage Renal Disease in Diabetes. Front. Endocrinol [Internet]. 2022 [access Feb 18 2023];13(1):873318. DOI: https://doi.org/10.3389/fendo.2022.873318
Carrero J, Elinder C. The Stockholm CREAtinine Measurements (SCREAM) project: Fostering improvements in chronic kidney disease care. Journal of Internal Medicine [Internet]. 2022 [access Feb 18 2023];291(1):254–268. DOI: https://doi.org/10.1111/joim.13418
González-Milán ZC, Escalona-González SO, Díaz-Pérez MJ, Laborí-Quesada P, Mulet-Duarte A, Pavón-Rojas AJ. Detección de enfermedad renal crónica occulta mediante determinación de albuminuria en pacientes con diabetes mellitus. Revista Cubana de Medicina General Integral [Internet]. 2021 [access Feb 18 2023];37(4):e1539. Disponible en: https://revmgi.sld.cu/index.php/mgi/article/view/1539
Zeng YQ, Qin ZA, Guo ZW. Non- linear relationship between basal serum albumin concentration and cardiac arrest in critically ill patients with end- stage renal disease: a cross-sectional study. BMJ Open [Internet]. 2022 [access Feb 18 2023];12(1):e051721. DOI: https://doi.org/10.1136/bmjopen-2021-051721
Lee EJ, Hwang HB, Han SH, Ham YR, Shin JA, Lee KW, et al. Serum Growth Differentiation Factor-15/Albumin Ratio as a 2-Year Survival Marker of End-Stage Renal Disease Patients Initiating Maintenance Hemodialysis. Diagnostics [Internet]. 2022 [access Feb 18 2023];12(1):257. DOI: https://doi.org/10.3390/diagnostics12020257
Xie Y, Feng X, Gao Y, Zhan X, Peng F, Zhou Q, et al. Association of albumin to non-high-density lipoprotein cholesterol ratio with mortality in peritoneal dialysis patients. Renal Failure [Internet]. 2024 [access Feb 18 2023];46(1):1-15. DOI: https://doi.org/10.1080/0886022X.2023.2299601
Laville S, Couturier A, Lambert O, Metzger M, Mansencal N, Jacquelinet C, et al. Urea levels and cardiovascular disease in patients with chronic kidney disease. Nephrol Dial Trasplant [Internet]. 2022 [access Feb 18 2023];38(1):184-192. DOI: https://doi.org/10.1093/ndt/gfac045
Okazaki M, Obi Y, Shafi T, Rhee CM, Kovesdy CP, Kalantar-Zadeh K. Residual kidney function and cause-specific mortality among incident hemodialysis patients. Kidney International Reports [Internet]. 2023 [access Feb 18 2023];8(10):1989-2000. DOI: https://doi.org/10.1016/j.ekir.2023.07.0320
Wouda R, Vogt L, Hoorn E. Personalizing potassium management in patients on haemodialysis. Nephrology Dialysys Transplantation [Internet]. 2021 [access Feb 18 2023];36(1):13-18. DOI: https://doi.org/10.1093/ndt/gfaa213
Rooij E, Dekker F, Cessie S, Hoorn E, Fijter J, Hoogeveen E, et al. Serum potassium and mortality risk in hemodialysis patients: a cohort study. Kidney medicine [Internet]. 2022 [access Feb 18 2023];4(1):100379. DOI: https://doi.org/10.1016/j.xkme.2021.08.013
Nee R, Fisher E, Yuan C, Agodoa L, Abbott K. Pre-End-Stage Renal Disease Care and Early Survival among Incident Dialysis Patients in the US Military Health System. J Nephrol [Internet]. 2017 [access Feb 18 2023];45(1):464–472. DOI: https://doi.org/10.1159/000475767
Fu E, Evans M, Carrero J, Putter H, Clase C, Caskey F, et al. Timing of dialysis initiation to reduce mortality and cardiovascular events in advanced chronic kidney disease: nationwide cohort study. BMJ [Internet]. 2021 [access Feb 18 2023];375(1):e066306. DOI: https://doi.org/10.1136/bmj-2021-066306
Sousa H, Ribeiro O, Costa E, Christensen AJ, Figueiredo D. Establishing the criterion validity of self-report measures of adherence in hemodialysis throughassociations with clinical biomarkers: A systematic review and meta-analysis. PLoS ONE [Internet]. 2022 [access Feb 18 2023];17(10): e0276163. DOI: https://doi.org/10.1371/journal.pone.0276163
Jia X, Tang X, Li Y, Xu D, Moreira P. Update of dialysis initiation timing in end stage kidney disease patients: is it a resolved question? A systematic literature review. BMC Nephrology [Internet]. 2023 [access Feb 18 2023];24(162):1-22. DOI: https://doi.org/10.1186/s12882-023-03184-4
Bossola M, Pepe G, Antoccico M, Severino A, Di Stasio E. Interdialytic weight gain and educational/cognitive, counseling/behavioral and psychological/affective interventions in patients on chronic hemodialysis: a systematic review and meta-analysis. Journal of Nephrology [Internet]. 2022 [access Feb 18 2023];35(1):1973-1983. DOI: 10.1007/s40620-022-01450-6
Zanandreia M, Cattafesta M, Martins C, Castro Pereira MP, Pires Soares FL, Zobole Peterle F, et al. Socioeconomic, clinical and nutritional factors on interdyalitic weight gain in haemodialysis users. Acta Paulista de Enfermagem [Internet]. 2024 [access Feb 18 2023];37(1):Eape02062. DOI: https://doi.org/10.37689/acta-ape/2024AO00020622
Miyasato Y, Hanna RH, Miyagi T, Narasaki Y, Kimura H, Morinaga J, et al. Associations of interdialytic weight gain in the long intervals with mortality and residual kidney function decline. Hemodialysis International [Internet]. 2023 [access Feb 18 2023];27(3):326-338. DOI: https://doi.org/10.1186/s12882-023-03184-4
Locham S, Naazie I, Canner J, Siracuse J, Al-Nouri O, Malas M. Incidence and risk factors of sepsis in hemodialysis patients in the United States. Journal of Vascular Surgery [Internet]. 2021 [access Feb 18 2023];73(3):1016-1021. DOI: https://doi.org/10.1016/j.jvs.2020.06.1256
Escalona-González SO, González-Milán ZC, Ricardo-Paez B. Enfermedad renal crónica como causa importante de mortalidad en pacientes con COVID-19 en Cuba. Revista Cubana de Medicina [Internet]. 2022 [access Feb 18 2023];61(Spl):e2704. Disponible en: https://revmedicina.sld.cu/index.php/med/article/view/2704
Hiyamuta H, Yamada S, Taniguchi M, Nakano T, Tsuruya K, Kitazono T. Causes of death in patients undergoing maintenance hemodialysis in Japan: 10-year outcomes of the Q-Cohort Study. Clinical and Experimental Nephrology [Internet]. 2021 [access Feb 18 2023];25(10):1121-1130. DOI: https://doi.org/10.1007/s10157-021-02089-6
Clerck D, Bonkain F, Van der Niepen P, Cools W. Vascular Access type and mortality in haemodialysis: a retrospective cohort study. BMC Nephrology [Internet]. 2020 [access Feb 18 2023];21(1):1-7. DOI: https://doi.org/10.1186/s12882-020-01889-4
Laham G, Pujol G, Guzman J, Boccia N, Abib A, Diaz C. Early start hemodialysis with a catheter may be associated with greater mortality: A propensity score analysis. Seminars in Dialysis [Internet]. 2023 [access Feb 18 2023];36(4):294-302. DOI: https://doi.org/10.1111/sdi.13157
He X, Liu Y. Effects of arteriovenous fistulas and central venous catheters on the cardiac function and prognosis of patients on maintenance hemodialysis. Pak J Med Sci [Internet]. 2023 [access Feb 18 2023];39(3):780-784. DOI: https://doi.org/10.12669/pjms.39.3.7151
Descargas
Publicado
Cómo citar
Número
Sección
Categorías
Licencia
Derechos de autor 2025 Sergio Orlando Escalona González, Zoraida Caridad González Milán , Katiuska Danay Rodríguez Espinoza , Raymar Molina Vega
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
