Table 1.
Demographic and clinical characteristics of 104 164 hemodialysis patients stratified by nine a priori selected groups of baseline serum globulin
| Globulin (g/dL) | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Characteristics | Total | <2.4 | 2.4– <2.6 | 2.6– <2.8 | 2.8– <3.0 | 3.0– <3.2 | 3.2– <3.4 | 3.4– <3.6 | 3.6– <3.8 | ≥3.8 | P-value |
| Patients, n (%) | 104 164 | 11 371 (11) | 11 283 (11) | 14 206 (14) | 15 090 (14) | 14 778 (14) | 11 120 (11) | 8818 (8) | 5898 (6) | 11 600 (11) | |
| Age (years) | 63 ± 15 | 65 ± 17 | 64 ± 16 | 64 ± 16 | 63 ± 15 | 63 ± 15 | 62 ± 14 | 62 ± 14 | 61 ± 14 | 60 ± 14 | <0.001 |
| Female (%) | 44 | 41 | 41 | 43 | 44 | 45 | 45 | 45 | 46 | 43 | <0.001 |
| Diabetes (%) | 58 | 45 | 52 | 56 | 59 | 62 | 63 | 64 | 65 | 62 | <0.001 |
| Race (%) | |||||||||||
| Caucasian | 47 | 75 | 64 | 55 | 48 | 41 | 37 | 33 | 31 | 27 | <0.001 |
| African American | 31 | 11 | 17 | 22 | 28 | 33 | 38 | 44 | 46 | 54 | <0.001 |
| Asians | 3 | 3 | 3 | 3 | 4 | 4 | 4 | 3 | 4 | 3 | <0.001 |
| Others | 4 | 2 | 3 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | <0.001 |
| Ethnicity (%) | |||||||||||
| Hispanics | 15 | 9 | 14 | 16 | 17 | 17 | 18 | 16 | 15 | 13 | <0.001 |
| Insurance (%) | 0.0785 | ||||||||||
| Medicare | 53 | 55 | 55 | 55 | 53 | 53 | 52 | 52 | 53 | 51 | |
| Medicaid | 7 | 5 | 5 | 6 | 7 | 7 | 8 | 9 | 9 | 10 | |
| Others | 40 | 40 | 40 | 40 | 40 | 40 | 40 | 40 | 39 | 38 | |
| Access type (%) | |||||||||||
| CVC | 78 | 69 | 71 | 73 | 76 | 79 | 82 | 83 | 84 | 86 | <0.001 |
| AV fistula | 15 | 24 | 21 | 19 | 16 | 13 | 11 | 10 | 9 | 7 | <0.001 |
| AV graft | 4 | 5 | 5 | 5 | 5 | 4 | 4 | 4 | 3 | 3 | <0.001 |
| AV other | 0.1 | 0.1 | 0.1 | 0.1 | 0.1 | 0.1 | 0.1 | 0 | 0.2 | 0 | <0.001 |
| Unknown | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 4 | 4 | <0.001 |
| Comorbidities (%) | |||||||||||
| ASHD | 14 | 14 | 14 | 14 | 14 | 15 | 14 | 14 | 14 | 14 | 0.54 |
| CHF | 36 | 33 | 34 | 35 | 37 | 37 | 38 | 39 | 38 | 38 | <0.001 |
| Other CVD | 15 | 15 | 15 | 15 | 15 | 15 | 15 | 15 | 15 | 16 | 0.19 |
| CBVD | 2 | 1 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | 0.1 |
| Hypertension | 51 | 50 | 51 | 51 | 52 | 52 | 52 | 51 | 51 | 51 | 0.93 |
| COPD | 5 | 6 | 5 | 5 | 5 | 5 | 5 | 5 | 5 | 5 | 0.02 |
| Cancer | 2 | 4 | 3 | 2 | 2 | 2 | 2 | 2 | 2 | 2 | <0.001 |
| HIV | 0.5 | 0.1 | 0.2 | 0.2 | 0.2 | 0.2 | 0.4 | 0.5 | 0.7 | 2.3 | <0.001 |
| Dyslipidemia | 25 | 25 | 25 | 25 | 25 | 25 | 25 | 25 | 25 | 24 | 0.064 |
| Liver disease | 2 | 1 | 1 | 1 | 1 | 1 | 2 | 2 | 2 | 3 | <0.001 |
| Alcohol | 0.2 | 0.1 | 0.2 | 0.2 | 0.2 | 0.2 | 0.2 | 0.2 | 0.3 | 0.4 | <0.0001 |
| Substance abuse | 0.2 | 0.1 | 0.2 | 0.1 | 0.2 | 0.2 | 0.4 | 0.3 | 0.3 | 0.5 | <0.001 |
| Serum laboratory values | |||||||||||
| Albumin (g/dL) | 3.5 ± 0.5 | 3.62 ± 0.48 | 3.62 ± 0.46 | 3.6 ± 0.45 | 3.57 ± 0.45 | 3.53 ± 0.45 | 3.48 ± 0.44 | 3.43 ± 0.45 | 3.37 ± 0.46 | 3.18 ± 0.49 | <0.001 |
| A:G ratio | 1.2 ± 0.3 | 1.6 ± 0.3 | 1.4 ± 0.2 | 1.3 ± 0.2 | 1.2 ± 0.2 | 1.1 ± 0.1 | 1.0 ± 0.1 | 0.9 ± 0.1 | 0.9 ± 0.1 | 0.7 ± 0.2 | <0.001 |
| ALP (IU/L) | 87 (69–115) | 77 (62–98) | 80 (64–103) | 83 (66–107) | 85 (68–110) | 87 (69–113) | 90 (72–119) | 93 (74–125) | 97 (76–131) | 103 (78–145) | <0.001 |
| AST (IU/L) | 22 ± 14 | 20 ± 13 | 20 ± 11 | 20 ± 13 | 20 ± 13 | 21 ± 14 | 22 ± 12 | 23 ± 15 | 23 ± 15 | 27 ± 19 | <0.001 |
| Bicarbonate (mEq/L) | 24 ± 2.7 | 24 ± 3 | 23 ± 3 | 24 ± 3 | 24 ± 3 | 24 ± 3 | 24 ± 3 | 24 ± 2.6 | 24 ± 3 | 24 ± 3 | <0.001 |
| Calcium (mg/dL) | 9.1 ± 0.6 | 9 ± 0.6 | 9 ± 0.6 | 9 ± 0.5 | 9.1 ± 0.5 | 9.1 ± 0.6 | 9.1 ± 0.5 | 9.1 ± 0.6 | 9.2 ± 0.6 | 9.2 ± 0.6 | <0.001 |
| Creatinine (g/dL) | 5.9 ± 2.4 | 5.6 ± 2.3 | 5.8 ± 2.4 | 5.8 ± 2.3 | 5.9 ± 2.4 | 5.9 ± 2.3 | 5.9 ± 2.4 | 5.9 ± 2.4 | 5.8 ± 2.3 | 5.9 ± 2.4 | <0.001 |
| Ferritin (ng/mL), median (IQR) | 284 (165–488) | 273 (161–479) | 261 (154–441) | 258 (153–438) | 269 (158–450) | 278 (159–467) | 287 (170–484) | 298 (173–511) | 316 (183–537) | 373 (208–660) | <0.001 |
| Hemoglobin (g/dL) | 11.1 ± 1.2 | 11.1 ± 1.1 | 11.2 ± 1.1 | 11.2 ± 1.1 | 11.2 ± 1.1 | 11.1 ± 1.1 | 11.1 ± 1.1 | 11.1 ± 1.2 | 11 ± 1.2 | 10.7 ± 1.3 | <0.001 |
| iPTH (pg/mL), median (IQR) | 313 (196–485) | 293 (187–449) | 307 (195–468) | 316 (200–488) | 321 (208–491) | 324 (207–503) | 328 (203–506) | 320 (198–501) | 314 (193–488) | 289 (171–465) | 0.173 |
| ISAT (%) | 23 ± 9 | 25 ± 10 | 24 ± 9 | 23 ± 8 | 23 ± 8 | 22 ± 8 | 22 ± 9 | 23 ± 9 | 23 ± 9 | 24 ± 11 | <0.001 |
| KRU (mL/min/1.73 m2), median (IQR) | 3 (2–5) | 3 (2–6) | 3 (2–6) | 3 (2–6) | 3 (2–6) | 3 (2–5) | 3 (2–5) | 3 (2–5) | 3 (2–5) | 3 (1–5) | <0.001 |
| LDL (IU/L) | 80 ± 36 | 79 ± 36 | 79 ± 35 | 81 ± 36 | 81 ± 36 | 81 ± 35 | 81 ± 36 | 81 ± 36 | 80 ± 35 | 75 ± 34 | <0.001 |
| nPCR (g/kg/day) | 0.79 ± 0.22 | 0.82 ± 0.23 | 0.81 ± 0.22 | 0.8 ± 0.22 | 0.8 ± 0.21 | 0.8 ± 0.22 | 0.78 ± 0.21 | 0.78 ± 0.21 | 0.76 ± 0.21 | 0.74 ± 0.21 | <0.001 |
| Phosphorus (mg/dL) | 4.9 ± 1.1 | 4.8 ± 1.2 | 4.9 ± 1.2 | 4.9 ± 1.1 | 5 ± 1.1 | 5 ± 1.1 | 4.9 ± 1.1 | 4.9 ± 1.1 | 4.9 ± 1.1 | 4.9 ± 1.1 | 0.002 |
| Potassium (mEq/L) | 4.4 ± 0.5 | 4.4 ± 0.5 | 4.4 ± 0.5 | 4.4 ± 0.5 | 4.4 ± 0.5 | 4.4 ± 0.5 | 4.4 ± 0.5 | 4.4 ± 0.5 | 4.4 ± 0.5 | 4.4 ± 0.5 | <0.001 |
| Sodium (mEq/L) | 138 ± 3 | 139 ± 3 | 138 ± 3 | 138 ± 3 | 138 ± 3 | 138 ± 3 | 138 ± 3 | 138 ± 3 | 137 ± 3 | 137 ± 3 | <0.001 |
| TIBC (mg/dL) | 225 ± 49 | 228 ± 47 | 232 ± 47 | 231 ± 47 | 230 ± 48 | 227 ± 48 | 223 ± 49 | 221 ± 49 | 217 ± 50 | 205 ± 52 | <0.001 |
| Total protein (g/dL) | 6.6 ± 0.7 | 5.8 ± 0.5 | 6.1 ± 0.5 | 6.3 ± 0.5 | 6.5 ± 0.5 | 6.6 ± 0.5 | 6.8 ± 0.4 | 6.9 ± 0.5 | 7.0 ± 0.5 | 7.5 ± 0.6 | <0.001 |
| WBC count (×103/mm3) | 7.8 ± 2.7 | 7.5 ± 3.3 | 7.6 ± 2.5 | 7.7 ± 2.5 | 7.8 ± 2.5 | 7.8 ± 2.3 | 8 ± 2.6 | 8 ± 2.5 | 8 ± 2.6 | 8 ± 3 | <0.001 |
| BMI (kg/m2) | 28 ± 7 | 27 ± 6 | 28 ± 7 | 28 ± 7 | 28 ± 7 | 29 ± 7 | 29 ± 8 | 29 ± 8 | 29 ± 8 | 28 ± 8 | <0.001 |
| Post-HD weight (kg) | 80 ± 22 | 76 ± 19 | 78 ± 21 | 79 ± 21 | 80 ± 22 | 81 ± 23 | 82 ± 23 | 83 ± 24 | 82 ± 24 | 82 ± 25 | <0.001 |
| Blood pressure (mmHg) | |||||||||||
| Post-HD systolic | 144 ± 18 | 143 ± 18 | 144 ± 18 | 144 ± 18 | 145 ± 18 | 145 ± 18 | 145 ± 18 | 144 ± 19 | 144 ± 18 | 142 ± 19 | 0.0003 |
| Post-HD diastolic | 76 ± 11 | 74 ± 11 | 75 ± 11 | 75 ± 11 | 76 ± 11 | 76 ± 11 | 76 ± 11 | 76 ± 11 | 76 ± 11 | 76 ± 11 | <0.001 |
| spKt/v | 1.47 ± 0.32 | 1.51 ± 0.32 | 1.5 ± 0.32 | 1.49 ± 0.32 | 1.47 ± 0.31 | 1.47 ± 0.32 | 1.45 ± 0.32 | 1.43 ± 0.31 | 1.43 ± 0.32 | 1.4 ± 0.31 | <0.001 |
CVC, central venous catheter; AV, arteriovenous; ASHD, atherosclerotic heart disease; CHF, congestive heart failure; CVD, cardiovascular disease; CBVD, cerebrovascular disease; COPD, chronic obstructive pulmonary disease; iPTH, intact parathyroid hormone; ISAT, iron saturation; KRU, residual urea clearance; LDL, low-density lipoprotein; TIBC, total iron-binding capacity; BMI, body mass index; HD, hemodialysis; spKt/V, single-pooled Kt/V.
Values are presented as mean ± SD unless stated otherwise. Percentage may not add up to 100% due to rounding.