sf36 quality of life and mortality across different levels of serum albumin in patients with hemodialysis

Background: patients on hemodialysis (hd) generally display a significant decrease in the quality of life owing to comorbidities, malnutrition, and inflammation. methods: in this multicenter prospective study, the sf36 (short form with 36 questions scored between 0 and 100) and relevant demographic data and comorbidities (charlson comorbidity index); nutritional factors, and c-reactive protein (crp) were evaluated in 416 hd patients in september 2012. hospitalization and mortality were assessed in a median of a 28 month follow-up. results: the sf36 score in survived patients was 53.6 ± 19.3 versus 41.6 ± 22.4 in the non-survived patients (p < 0.001). there were significant adjusted inverse correlation between the sf36 score and age (r = -0.14, p = 0.005), diabetes (r = -0.13, p = 0.009), cci (r = -0.24, p < 0.001), serum crp level (r = -0.13, p = 0.03), serum ipth level (r = -0.19, p < 0.001), and also significant adjusted direct correlation with serum albumin (r = 0.15, p = 0.003), and serum creatinine (r = 0.12, p = 0.04). in cox proportional hazard models adjusting for age, gender, dialysis vintage, diabetes and serum albumin, the hazard ratio of death for every 10 unit decrease in sf36 score was 1.10 (95% ci: 1.04 - 1.22; p = 0.006). the adjusted hazard ratio for quintiles of serum albumin as ≤ 3.60, > 3.60 - 3.85, > 3.85 - 4.00, > 4.00 - 4.20, > 4.20 (reference) g/dl was respectively 3.69 (1.98 - 6.89), 2.08 (1.10 - 3.94), 1.91 (0.97 - 3.85), 1.10 (0.76 - 1.49). serum albumin revealed a strong association with mortality such that hazard ratio for every 1 g/dl decrease in serum albumin was 6.28 (95% ci: 3.80 - 10.42; p < 0.001). conclusions: in patients with hemodialysis, sf36 shows significant association with serum albumin, comorbidities, inflammation, and clinical outcome.