Effect of Blood Cadmium Level on Mortality in Patients Undergoing Maintenance Hemodialysis.
Medicine (Baltimore)
; 94(42): e1755, 2015 Oct.
Article
in En
| MEDLINE
| ID: mdl-26496294
ABSTRACT
Previous studies of general populations indicated environmental exposure to low-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 (>0.521 µg/L; n = 312), intermediate BCL (0.286-0.521 µg/L; n = 313), and low BCL (<0.286 µg/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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cadmium
/
Kidney Failure, Chronic
Type of study:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Medicine (Baltimore)
Year:
2015
Document type:
Article