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Revista da Associação Médica Brasileira

versão impressa ISSN 0104-4230versão On-line ISSN 1806-9282

Resumo

MORSCH, Cássia; GONCALVES, Luiz Felipe  e  BARROS, Elvino. End-stage renal disease severity index, clinical indicators and mortality of hemodialysis patients. Rev. Assoc. Med. Bras. [online]. 2005, vol.51, n.5, pp.296-300. ISSN 0104-4230.  http://dx.doi.org/10.1590/S0104-42302005000500023.

OBJECTIVE: Comorbidity is a major factor influencing mortality in hemodialysis patients. Kt/V, hematocrit and albumin levels have also been associated with mortality in these patients. The purpose of this study was to evaluate the severity of comorbidity, Kt/V, hematocrit and albumin levels as predictors of mortality in patients on hemodialysis therapy. METHODS: Forty patients were followed up during 12 months and assessed in relation to social demographic characteristics, time on dialysis therapy, presence of diabetes, Kt/V, hematocrit and albumin levels, also comorbidities. The impact of comorbidity on mortality was assessed by the end-stage renal disease severity index (ESRD-SI). RESULTS: Mean ESRD-SI scores for survivals (85%) and deaths (15%) were 22±14.8 vs. 44±12.4 (p<0.001), and for diabetic (29%) and non-diabetic patients (71%), 40±15.1 vs. 19±12.5 (p<0.001). An inverse correlation was observed between ESRD-SI scores and albumin (r=-0.475; p<0.005). Albumin levels =3.6 g/dL were mostly observed (82%) in patients without diabetes (p=0.021). A correlation was observed between hematocrit and albumin levels (r=0.544; p<0.001). For each 1-point increase in the ESRD-SI scores, there was a 10% increase in the risk of death (p=0.0093). CONCLUSION: The ESRD-SI is useful to assess the severity of comorbidities and to predict mortality in hemodialysis patients.

Palavras-chave : Hemodialysis; Morbidity; Mortality; Diabetes Mellitus.

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