Correlation of Albumin-globulin Ratio with Prognosis in Maintenance Hemodialysis Patients
Objective:To analyze the correlation between the ratio of albumin-globulin(AGR)and the prognosis of main-tenance hemodialysis(MHD)patients.Methods:The clinical data of 320 MHD patients admitted to the First People's Hospital of Shaoguan City from January 2010 to December 2020 were reviewed,and the AGR level fluctuated between 0.41 and 3.26.According to the median AGR(1.21),the patients were divided into high AGR group(n =162)and low AGR group(n =158),with 94 cases in each group.The differences in clinical data between the two groups were compared,the causes of death were analyzed,the survival of the two groups was analyzed by Kaplan-Meier method,and the effects of AGR on cardiovascular death and all-cause death in MHD patients were analyzed by COX proportional risk model.Results:(1)The age,age-adjusted charlson comorbidification index(ACCI),white blood cell count,platelet count,fibrinogen,globulin level,cardiovascular disease rate and diabetes rate of patients in the low AGR group were higher than those in the high AGR group,and the serum phosphorus,serum creatinine,blood urea nitrogen and albumin levels were lower than those in the high AGR group.The difference was statistically significant(P<0.05).(2)The median follow-up time was 41.35 months.During the follow-up,4 cases(2.13%)were transferred to peritoneal dialysis,1 case(0.53%)was transplanted kidney,and 2 cases(1.06%)were lost to follow-up.The causes of death were:cardiovascular disease in 44 cases(70.97%),infection in 9 cases(1 4.52%),tumor in 3 cases(4.84%)and other 6 cases(9.68%).(3)Kaplan-Meier analysis showed that the cumulative all-cause survival(P<0.001)and cumulative cardiovascular disease survival(P<0.001)of patients in the high AGR group were better than those in the low AGR group.(4)COX regression analysis showed that in the unadjusted model,the risk of all-cause death(HR:3.842)and cardiovascular death(HR:3.752)were significantly increased in the low-AGR group,and after adjusting for gender and ACCI,the risk of all-cause death(HR:2.657)and cardiovascular death(HR:After further adjustment for white blood cell count,platelet count,hemoglobin,blood urea nitrogen,blood uric acid,se-rum phosphorus,serum creatinine,fibrinogen and other variables,low AGR remained an independent risk factor for all-cause death(HR:2.740)and cardiovascular death(HR:2.651).Conclusion:Low AGR is an independent risk factor for cardiovascular and all-cause mortality in MHD patients,and it can serve as a reliable prognostic indicator for MHD patients.
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