Effect of blood cadmium level on mortality in patients undergoing maintenance hemodialysis

Ching Wei Hsu*, Tzung Hai Yen, Kuan Hsing Chen, Dan Tzu Lin-Tan, Ja Liang Lin, Cheng Hao Weng, Wen Hung Huang

*此作品的通信作者

研究成果: 期刊稿件文章同行評審

12 引文 斯高帕斯(Scopus)

摘要

Previous studies of general populations indicated environmental level cadmium increases mortality. However, the effect of cadmium exposure on maintenance hemodialysis (MHD) patients is unclear. A total of 937 MHD patients from 3 centers in Taiwan were enrolled in this 36-month observational study. Patients were stratified by baseline blood cadmium level (BCL) into 3 groups: high BCL (>0.521mg/L; n=312), intermediate BCL (0.2860.521mg/L; n=313), and low BCL (<0.286mg/L; n=312). The mortality rates and causes of death were analyzed. The analytic results demonstrated patients in the high BCL group had a significantly higher prevalence of malnutrition and inflammation than patients in the low and intermediate BCL groups. After 3 years of follow-up, 164 (17.5%) patients died and the major cause of death was cardiovascular disease. A Cox multivariate analysis indicated the high BCL group had increased hazard ratios (HRs) for all-cause mortality (HR=1.72; 95% confidence interval [CI]: 1.14-2.63; P=0.018), cardiovascular-related mortality (HR=1.85; 95% CI: 1.09-3.23; P=0.032), and infection-related mortality (HR=2.27; 95% CI: 1.12-4.55; P=0.035). A Cox multivariate analysis of MHD patients who never smoked (n=767) indicated the high BCL group had increased HRs for all-cause mortality (HR=1.67; 95% CI: 1.04-2.63; P=0.048) and cardiovascular-related mortality (HR=2.08; 95% CI: 1.08-4.00; P=0.044). In conclusion, BCL is an important determinant of mortality in MHD patients. Therefore, MHD patients should avoid cadmium exposure as much as possible, such as tobacco smoking and eating cadmium-containing foods.

原文英語
頁(從 - 到)e1755
期刊Medicine (United States)
94
發行號42
DOIs
出版狀態已出版 - 01 10 2015
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© 2015 Wolters Kluwer Health, Inc. All rights reserved.

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