https://orcid.org/0000-0001-8755-7968
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Abstract
Objective
Malnutrition and inflammation are associated with mortality in peritoneal dialysis (PD) patients. Serum albumin and non-high-density lipoprotein cholesterol (non-HDL-C) are independently associated with mortality in PD patients. Combining albumin and non-HDL-C with mortality may be more plausible in clinical practice.
Methods
This retrospective cohort study included 1954 Chinese PD patients from 1 January 2009 to 31 December 2016. Kaplan–Meier curve was used to determine the relationship between albumin to non-HDL-C ratio and all-cause mortality. Cox regression analysis was applied to assess the independent predictive value while adjusting for confounding factors. Competitive risk analysis was used to examine the effects of other outcomes on all-cause mortality prognosis.
Results
In the 33-month follow-up period, there were 538 all-cause deaths. Kaplan–Meier analysis presented significant differences in all-cause mortality. Multivariate Cox regression showed that the risk of all-cause mortality was lower in the moderate group (9.36–12.79) (HR, 0.731; 95% CI, 0.593–0.902, p = 0.004) and the highest group (>12.79) (HR, 0.705; 95% CI, 0.565–0.879, p = 0.002) compared to the lowest group (≤9.36). Competitive risk analysis revealed significant differences for all-cause mortality (p < 0.001), while there was no statistical significance for other competing events.
Conclusions
Low albumin to non-HDL-C ratio was associated with a high risk of all-cause mortality in PD patients. It may serve as a potential prognostic biomarker in PD patients.
Acknowledgments
The authors are grateful to all the participants in this study.
Authors Contribution
YJX: Project development, Manuscript writing; XRF: Data analysis and data collection; YQG: Data analysis; XJZ: Data collection; FFP: Data collection; QZ: Provide statistical support; XFW: Data collection; XYW: Assist in data analysis; NT: Data collection; QDX: Data collection; JBL: Data management; JL: Project development, Manuscript editing, Funding. YQW: Data management, Manuscript editing, Funding. All authors have read and approved the manuscript.
Data availability statement
All data generated or analyzed during this study are included in this published article.
Geolocation information
The research conducted in this study focuses on a specific geographic area located in Guangzhou, Guangdong Province, China.
DeclarationsEthics and consent to participate
All procedures performed in this study involving human participants were following the ethical standards of the institution (IRB approval number 2019-hg-ks-04) and with the 1964 Helsinki Declaration as well as its later amendments or comparable ethical standards. This study was warranted by the Institutional Review Board of two PD.
Consent to participate and publication
Owing to we had collected the existing medical records, written informed consent was not required.
Consent for publication
The data released by our research would not compromise anonymity or confidentiality, nor violate local data protection laws. The researchers disclosed no names or other identifying information related to respondents and their parents or guardian in this manuscript.
Competing Interests
The authors declared that they had no financial conflicts of interest.
Disclosure statement
No potential conflict of interest was reported by the author(s).