Blood cadmium level's association with 18-month mortality in diabetic patients with maintenance haemodialysis.
Nephrol Dial Transplant
; 26(3): 998-1005, 2011 Mar.
Article
em En
| MEDLINE
| ID: mdl-20667996
ABSTRACT
BACKGROUND:
Cadmium exposure is related to severity of diabetes and diabetes-related organ damage in diabetic patients. Elevated blood cadmium levels (BCLs) are well known in maintenance haemodialysis (MHD) patients but the clinical significance in diabetic MHD patients remains unknown.METHODS:
A total of 212 diabetic MHD patients were enrolled in this 18-month prospective study and were categorized into three equal groups according to the basal BCL high (> 0.889 µg/L; n = 71), middle (0.373-0.889 µg/L; n = 70) and low (< 0.373 µg/L; n = 71) BCL groups. The mortality and cause of death were recorded and analysed longitudinally.RESULTS:
Patients with high BCL had trends of higher white blood cell counts, glycosylated haemoglobin, phosphate and blood lead levels than other group patients. At the end of the follow-up, 31 patients had died. Kaplan-Meier analysis showed that the high BCL group patients had a higher mortality than other group patients (log-rank test, P = 0.036). Cox multivariate analysis demonstrated that logarithmic BCL was associated with increased hazard ratios (HR) for the all-cause mortality (HR = 2.336, 95% confidence intervals [CI] = 1.099-4.964, P = 0.027) in diabetic MHD patients. Similarly, if the low BCL group was the reference, the high BCL was associated with increased HR for all-cause mortality (HR = 2.865, 95% CI = 1.117-7.353, P = 0.043) in these patients.CONCLUSIONS:
The study results first demonstrated that BCL is associated with increased HR for 18-month all-cause mortality in diabetic MHD patients. Avoiding smoking and high cadmium-containing food may be important in these patients.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cádmio
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Diálise Renal
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Diabetes Mellitus
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article