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논문분류	춘계학술대회 초록집
제목	Pre-hemodialysis blood urea nitrogen to creatine ratio for prediction of mortality in hemodialysis patients
저자	Ha Yeon Kim1, Ahn Na KOO1, Young-Eun Jo1, Rim Lee1, Chang Seong Kim1, Eun Hui Bae1, Seong Kwon Ma1, Dong-Chan Jin2, Soo Wan Kim1
출판정보	2018; 2018(1):
키워드	Blood urea nitrogen \| Creatinine \| Hemodialysis \| Mortality
초록	Objectives: The associatetion between blood urea nitrogen to creatinine ratio (BUN/Cr ratio) and mortality remains undefined. Methods: Retrospective analysis was performed on data from the End-Stage Renal Disease Registry of the Korean Society of Nephrology. A total of 24,852 patients starting hemodialysis were included from 2004 to 2015. The association between BUN/Cr ratio with overall survival was analyzed using a Cox regression model. Moreover, we compared the renal parameters including BUN/Cr ratio, Kt/V (single pool), pre-hemodialysis and post-hemodialysis BUN level for sensitivity and specificity using receiver operative characteristic (ROC) curve. Results: During 10-year follow-up period, 9,008 patients died from any cause, and 10-year mortality of hemodialysis patients was 36.2 %. The increase in BUN/Cr ratio was positively associated with an increased risk for all-cause mortality (HR 1.005, 95% CI 1.003–1.007, p < 0.001). On the other hand, post-hemodialysis BUN level was not different between survivor and non-survivor group, and did not show any significant relevance for all-cause mortality. Crude AUC of pre-hemodialysis BUN levels was 0.533 (95% CI, 0.526 - 0.540, p < 0.001), post- hemodialysis BUN levels was 0.504 (95% CI, 0.497 - 0.511 p = 0.222), Kt/V was 0.529 (95% CI ,0.522 - 0.536, p < 0.001), and pre-hemodialysis BUN/Cr ratio was 0.558 (95% CI, 0.551 - 0.565, p < 0.001). After adustment, AUC of pre-hemodialysis BUN levels was 0.771 (95% CI, 0.726 - 0.815, p < 0.001), post- hemodialysis BUN levels was 0.773 (95% CI, 0.729 – 0.816 p < 0.001), Kt/V was 0.775 (95% CI ,0.731 - 0.819, p < 0.001), pre-hemodialysis BUN/Cr ratio was 0.778 (95% CI, 0.733 - 0.818, p < 0.001). Conclusions: Post-hemodialysis BUN levels is not significant indicator in predicting mortalities in hemodialysis patients. Pre-hemodialysis BUN/Cr ratio is more accurate than Kt/V for prediction of mortality in hemodialysis patients.
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