Risk factors and their association with mortality in patients undergoing long-term hemodialysis or/and kidney transplant patients or late-stage chronic kidney disease: A single center, prospective observational study.

Cardiovascular diseases (CVDs) are a very common occurrence in patients with chronic kidney disease (CKD) and that was the main cause of mortality in these patients. The aims of the present study were to examine the effects of inflammation, malnutrition, and an oxidative stress in patients undergoing long-term hemodialysis or/and kidney transplant patients or patients with late-stage CKD, with its coherent consequences during a 38-month follow-up period. The present study included 137 patients with renal insufficiencies (48 patients had CKD, 29 patients had kidney transplants, and 60 CKD patients underwent hemodialysis [HD] and 39 normal individuals [controls]; aged 49 ± 20 years, 96 males and 80 females). All patients with renal insufficiencies were dialyzed 3 times a week for 4 to 5 hours/day (dialysis commenced in March 2017 and continued for 38 months). Biochemical parameters, Paraoxonoase (PON)-1 status, and inflammatory-markers were assayed using the standard laboratory protocols. The Kaplan-Meier method with the log-rank test was used for survival analysis of CKD patients. Older aged patients had a higher risk of developing CKD than the controls (P < .001). The albumin level, body mass index, and total cholesterol were found to be lower, and the triglyceride value was found to be higher in the patients of the HD group (P < .05 for all). The patients of the HD group exhibited a higher activity of PON-1 than the patients who received a kidney transplant (P < .001). The control patients had a higher activity of PON-1 than the patients of the HD group, those with CKD, and those of the kidney transplant group (P < .001 for all). Following a follow-up of 16 patients with CKD for 38 months, 15 patients undergoing HD succumbed due to cardiovascular diseases and one patient received a kidney transplant. At 8 to 10-month of follow-up 85% of survival function was noted. As the disease progressed, the survival function decreased to 30% due to the malnutrition in patients with CKD. Lipid oxidation and malnutrition/inflammation are associated with in various stages of CKD patients. With progressing CKD patients' biomarkers of lipid oxidation and malnutrition/inflammation show an increasing trend.