Shimoda T, et al. - In hemodialysis patients, researchers assessed the associations of reduced functional mobility, muscle weakness, and low serum albumin—both alone and in combination—with all-cause mortality. In this patient populace, the combined assessment of reduced functional mobility, muscle weakness, and low serum albumin was found to be related to poorer prognosis. In these subjects, the combination of reduced functional mobility, muscle weakness, and low serum albumin was shown to have utility for accurate prediction of prognosis.

Methods

• In this retrospective study, 490 patients treated between July 2010 and October 2016 were enrolled.
• Using Cox proportional hazard regression analysis, the independent prognostic impact of the combination of reduced functional mobility, muscle weakness, and low serum albumin on survival was estimated.
• By combining the associations of reduced functional mobility, muscle weakness, and low serum albumin vs each component alone based on the receiver-operating characteristic curves, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI), researchers estimated the increases in predictive capacity.

Results

• Overall, 314 hemodialysis patients were included, and death of 56 was reported during the 6.5-year follow-up period.
• The high Combined score group vs the low Combined score group demonstrated a significantly lower cumulative survival rate (hazard ratio, 3.30; 95% confidence interval, 1.59-6.87; P=.001).
• Discrimination of patients at high risk of mortality was improved by the addition of Combined score to patient characteristics, as suggested by both NRI and IDI (NRI, 0.038 95% CI: 0.096 - 0.064, P < .001 IDI, 0.029 95% CI: 0.004 - 0.055, P=.025).