Total Bilirubin in Prognosis for Mortality in End-Stage Renal Disease Patients on Peritoneal Dialysis Therapy

J Am Heart Assoc. 2017 Dec 23;6(12):e007507. doi: 10.1161/JAHA.117.007507.

Abstract

Background: Evidence regarding bilirubin's antioxidant properties and predictive roles is growing. However, it is unclear whether serum bilirubin would have a prognostic impact on survival of patients with regular peritoneal dialysis.

Methods and results: We used the Taiwan Renal Registry Data System utilizing its 2005-2012 data set. Data from patients on regular peritoneal dialysis were retrieved. The primary end point of observation was 3-year mortality. A total of 3704 patients (mean age 53.5 years, 44% male) were enrolled, and these patients were divided according to baseline serum total bilirubin levels (<0.3, 0.3-0.4, 0.4-0.5, 0.5-0.6, >0.6 mg/dL). Serum total bilirubin level was linearly related to age, incidence of hypertension, and type 2 diabetes mellitus. At the end of the observation period with a mean follow-up of 2.12±1.07 years, 1095 (30.6%) deaths were detected. Serum total bilirubin level and 3-year mortality rate presented a U-shaped relationship. Those with serum total bilirubin 0.5 to 0.6 mg/dL had the lowest 3-year mortality rate (24%). After adjustment for age, sex, underlying systemic disorders, medications, and laboratory discrepancies, serum total bilirubin still played an independent role for predicting 3-year mortality.

Conclusions: Baseline serum total bilirubin level is significantly associated with 3-year mortality among patients receiving regular peritoneal dialysis.

Keywords: bilirubin; dialysis; prognosis.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bilirubin / blood*
  • Biomarkers / blood
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / mortality*
  • Kidney Failure, Chronic / therapy
  • Male
  • Middle Aged
  • Peritoneal Dialysis*
  • Prognosis
  • Registries*
  • Retrospective Studies
  • Risk Factors
  • Survival Rate / trends
  • Taiwan / epidemiology
  • Time Factors

Substances

  • Biomarkers
  • Bilirubin