Comparison of serum albumin, C‐reactive protein and carotid atherosclerosis as predictors of 10‐year mortality in hemodialysis patients

Serum albumin, C-reactive protein (CRP), and the intima-medial thickness of the common carotid artery (CA-IMT) are associated with clinical outcomes in hemodialysis (HD) patients. However, it remains unclear which parameters are more reliable as predictors of long-term mortality. We measured serum albumin, CRP, and CA-IMT in 206 HD patients younger than 80 years old, and followed them for the next 10 years. One hundred sixty-eight patients (age: 57 ± 11 years, time on HD: 11 ± 7 years) were enrolled in the analyses. We divided all patients into three tertiles according to their albumin levels, and conducted multivariate analyses to examine the impact on 10-year mortality. Seventy-three (43.5%) patients had expired during the follow-up. Serum albumin was significantly lower in the expired patients than in the surviving patients (3.8 ± 0.3 vs. 4.0 ± 0.3, P 4.1 g/dL. In contrast, CRP and CA-IMT did not associate with total death. It follows from these findings that serum albumin is more superior as a mortality predictor compared with CRP and CA-IMT in HD patients.