PERIPHERAL EOSINOPHIL COUNT AS RISK FACTOR OF ALL-CAUSE ONE-YEAR MORTALITY IN HEMODIALYSIS PATIENTS; A RETROSPECTIVE COHORT STUDY FROM MEDAN, INDONESIA
Dokter RIRI MUZASTI1, Dr MUKHAMAD FARIED1
1Division of Nephrology & Hypertension, Department of Internal Medicine, Faculty of Medicine, University of North Sumater, Medan, Indonesia
Aim: This study was designed to investigate the association of POC with mortality in hemodialysis patients.
Background: Peripheral eosinophil count (POC) has revealed its novel role as a true immunoregulatory cell with roles in the modulation of lymphocytes, mast cells, and neutrophils. Renal impairment has been previously linked to POC, especially in hemodialysis patients. Studies in the general population have demonstrated that POC is associated with mortality risk.
Methods: This single-center retrospective study included patients aged ≥18 years old, undergoing routine twice-weekly hemodialysis for >60 days total, having baseline POC, and the first 91 days following the initiation of hemodialysis. POC was calculated by multiplying a percent fraction of the eosinophil with total white blood cell count.
Results: Of the 70 patients who met the inclusion and exclusion criteria, there were 26 deaths during 1 year of follow-up. Patients with baseline POC <150 cells/μL had the highest percentage of death (54.5%) and most of the patients with POC >350 cells/μL survived(92.3%), p = 0.008. Patients with baseline POC <150 cells/μL were strongly associated with higher mortality across all POC strata [odds ratio (OR): 3.08, 95% CI: 1.01-9.36], p = 0.047. Over the first three months after initiation of hemodialysis, the results were consistent. Patients with POC <150 cells/μL had the highest percentage of death (64.0%) and most of the patients with POC >350 cells/μL survived (88.9%), p = 0.001.
Conclusions: Lower baseline POC and lower POC over the first 3 months after HD initiation are associated with mortality in hemodialysis patients. Further studies are needed to understand the pathophysiology of POC as a prognostic marker for patients’ mortality after initiation of hemodialysis.
Biography:
Assistant Professor at Faculty of Medicine, Universitas Sumatera Utara, Division Nephrology and Hypertension, Departement of Internal Medicine, Medan, Indonesia. I am interested in investigating the mortality risk factors in hemodialysis patients, especially in adequacy, hypertension, nutrition, anemia, vascular calcification, single nucleotide polymorphism, and how to increase their survival and quality of life.