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Article

A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort Study

1
Department of Nephrology, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
2
Department of Nephrology, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
3
Department of Nephrology, Yokosuka Kyosai Hospital, Kanagawa 238-8558, Japan
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(10), 634; https://doi.org/10.3390/toxins12100634
Received: 26 August 2020 / Revised: 24 September 2020 / Accepted: 30 September 2020 / Published: 1 October 2020
(This article belongs to the Special Issue Chronic Kidney Disease (CKD) Studies on Humans and Animals)
Uremic toxins (UTs) generally accumulate in patients developing end-stage renal disease (ESRD). Although some kinds of UTs cause early death after starting hemodialysis (HD), it remains unknown whether the degree of excessive accumulation of various UTs is associated with worsening of prognosis. We retrospectively conducted this cohort study consisting of adult patients developing ESRD who initiated HD at the National Center for Global Health and Medicine from 2010 to 2019. We created a new uremic score, which was defined as the aggregate score of the following variables reflecting uremic state: elevated blood urea nitrogen, β2-microglobulin, and anion gap before starting HD. The primary outcome was early mortality within 1-year after HD commencement. The hazard ratio (HR) and 95% confidence interval (CI) for a one-point increase in uremic score was calculated with Cox proportional hazard models adjusted by baseline conditions. We included 230 participants, 16 of whom experienced the primary outcome of early mortality after HD commencement. Uremic score was significantly associated with the primary outcome (crude HR: 1.91, 95% CI 1.16–3.14; adjusted HR: 4.19, 95% CI 1.79–9.78). Our novel uremic score, reflecting accumulation of specific UTs, more precisely predicts early mortality after HD commencement. View Full-Text
Keywords: end stage renal disease; uremic toxins; mortality; hemodialysis end stage renal disease; uremic toxins; mortality; hemodialysis
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MDPI and ACS Style

Arai, Y.; Shioji, S.; Tanaka, H.; Katagiri, D.; Hinoshita, F. A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort Study. Toxins 2020, 12, 634. https://doi.org/10.3390/toxins12100634

AMA Style

Arai Y, Shioji S, Tanaka H, Katagiri D, Hinoshita F. A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort Study. Toxins. 2020; 12(10):634. https://doi.org/10.3390/toxins12100634

Chicago/Turabian Style

Arai, Yohei, Shingo Shioji, Hiroyuki Tanaka, Daisuke Katagiri, and Fumihiko Hinoshita. 2020. "A Novel Uremic Score Reflecting Accumulation of Specific Uremic Toxins More Precisely Predicts One-Year Mortality after Hemodialysis Commencement: A Retrospective Cohort Study" Toxins 12, no. 10: 634. https://doi.org/10.3390/toxins12100634

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