engleski

Plazma albumin concentracion and survival of patients on haemodialysis over sixty-five years of age

A great number of patients on haemodialysis suffered from malnutrition. The proportion of malnourished patients became greater with their age. Today, there is an increasing number of elderly patients on regular dialysis treatment. In the preterminal stage of their renal disease, they where placed on a diet with a restricted protein intake and a provision low in phosphate. One important factor of nutritional evaluation is plasma albumin concentration. We analysed the influence of plasma albumin concentration on the survival of patients over 65 years, who began dialysis between January 1, 1995 and December 31, 1999. There were 61 patients, 31 male and 30 female. Our observations lasted until June 30, 2002. During the first year of dialysis, 17 patients died (first group). Between one and two years 15 patients died (second group). After two to five years of treatment, 25 patients died (third group). Only 4 persons spent more than 5 years (fourth group) on dialysis. The average age in the first group was 71.4±4.3 years, in the second group 71.3±3.9 years, in the third group 70.3±4.4 years and in the fourth group 71±5.0 years (P=NS). At the beginning of the dialysis, the value of plasma albumin in the first group was 31.9±5.9 g/l*, 35.3±6.4 g/l in the second group, 38.1±6.6 g/l in the third group and 41.8±6.7 g/l in the fourth group* (*P<0.05). After one month on dialysis, the plasma albumin concentration for the second group was 36.2±6.3 g/l, after three months 37.5±6.9 g/l and after six months 36.5±6.9 g/l (P=NS). In the same period the third group had the following values: 39.1±5.7 g/l, 39.3±5.3 g/l and 39.1±4.3 g/l (P=NS), while the values of the fourth group were: 41.0±4.9 g/l, 43±4.3 g/l and 43.5±5.4 g/l (P=NS). It is obvious from these results that a greater plasma albumin concentration at the beginning of dialysis was connected with a better survival.Moreover, evaluation of the same values through sixmonths of treatment did not reveal any significant variation within the groups. Therefore, we can conclude that is very important to prevent malnutrition in patients before starting the dialysis treatment. Patients with a high plasma albumin concentration had a better survival rate.

albumin; survival; haemodilysis; elderly patients

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