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      • KCI등재후보

        혈액투석중인 만성신부전 환자의 사망률에 영향을 미치는 요인부석

        김경석(K . S . Kim),김진구(J . G . Kim),우상태(S . T . Woo),서상렬(S . Y . Suh),김향(H . Kim),권영주(Y . J . Kwon),표희정(H . J . Pyo),김용섭(Y . S . Kim),차대룡(D . R . Cha),조원용(W . Y . Jo),김형규(H . K . Kim),김창수(C . S . Kim), 대한내과학회 1998 대한내과학회지 Vol.54 No.3

        N/A Background: Several factors have been influenced to mortality of patients with end-stage renal disease treated with hemodialysis. We performed this study to evaluate the factors influencing to mortality in chronic hemodialysis patients in eight hemodialysis centers. Method: We analyzed retrospectively the demographic characteristics, risk stratification, Kamofsky scale, regularly tested laboratory finding(CBC, Blood chemistry), hospitalization rate, and gross mortality among 150 patients from June, 1994 to June 1996. Results: 1) A total of 150 patients were enrolled, male 91 and female 59 and mean age was about 53 years. 43 patients had diabetes and 107 patients had nondiabetes. The mean duration of hemodialysis was 48.2±24.7 months(range, 9-123months), 2) 82 patients(54.7%) required hospitalization during the 2 year follow-up period and the most common cause of hospitalization was cardiovascular disease. 3) A total of 43 patients(28.7%) had been died during the 2 year follow-up period and the most common cause of death was cerebrovascular disease. 4) In univariate analysis, advancing age, Kamofsky scale(<80 points), diabetic nephropathy as the underlying cause of ESRD, comorbid illness, high risk group in risk stratification, total HD duration, HD length per week, low serum albumin and creatitine concentration were all associated with significantly increased risk of death. In multivariate analysis, diabetic nephropathy as the underlying cause of ESRD and low serum albumin concentration were more highly associated with death probability. Conclusion: We conclude that diabetic nephropathy as underlying cause of ESRD and serum albumin concentration are more important elements in determining patient mortality.

      • SCOPUSKCI등재

        유지혈액투석 환자에 있어 영양상태와 염증지표의 관계에 대한 연구

        한상엽(S. Y. Han),조상경(S. K. Jo),윤종우(J. W. Yoon),신진호(J. H. Shin),이소영(S. Y. Lee),차대룡(D. R. Cha),권영주(Y. J. Kwon),조원용(W. Y. Cho),표희정(H. J. Pyo),정태시(T. S. Jung) 대한신장학회 2000 Kidney Research and Clinical Practice Vol.19 No.2

        N/A Malnutrition is known to be an independent risk factor of morbidity and mortality in hemodialysis patients. The causes of malnutrition were obsucure. Several catabolic cytokines such as interleukin-1β(IL-1β), interleukin-6(IL-6), and tumar necrosis fac-tor-α(TNF-α) were reported to be elevated in hemo-dialysis patients with malnutrition, To evaluate the nutritrional status and relationship among cytokines IL-1β, TNF-α, and various parameters, we performed a cross-sectional study in maintenance hemodialysis patients who have undergone for six months at least. Patients who were taking steroid. showed any sign of infection, or had residual renal function were excluded from the study. Nutritional status was classified into well nourished(A), mild to moderate malnutrition(B), and severe malnutrition(C) by using subjective global assessment(SGA). Patients were divided into two groups (I: A, II: B and C) based on SGA. The level of IL-10, TNF-a were estimated by ELISA. Total patients were 23(M/F:15/8 mean age 52.0±1.56yrs). There were significant differences in weight changes for 6 months, CRP, and SGA between two groups based on the level of serum albumin(using 4.0g/dL as a cutoff value). Moreover, based on SGA, there were significant differences in age, BMI, CRP, and albumin between the group I and IL Serum albumin levels was directly correlated with transferrin(r=0.302, p=0.04), and was inversly correlated with age(r=-0.329, p=0.007). TNF- u was inversly correlated with Kt/Vueea(r=-0.291, p= 0.047), and directly correlated with the duration of maintenance hemodialysis(r=0,346, p=0.036), BMI(r-0.453, p<0.05). These data support the fact that albumin and CRP can be a good marker of nutritional status in maintenance hemodialysis patient. However cytokines and transferrin might not be related to nutritional status.

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