Mortality in Hemodialysis Patients: Predict and (Trying to) Reduce it

Abstract

Mortality risk scores for hemodialysis patients have been developed also in the past, but with low clinical applicability. Floege has recently developed a score in 11.500 hemodialysis incident European patients, able to predict mortality risk after 1 and 2 years. The principal determinants of the score were: older age, low body mass index, history of cancer, high levels of C-reactive protein and low levels of albumin. The relevance of the score is due to its high applicability also to an external cohort of hemodialysis patients (the DOPPS study patients). The increased incidence of cancers in hemodialysis patients represents another important situation, in which we need to improve our everyday clinical practice, especially for cancers frequent in dialysis patients (kidney/renal pelvis and bladder), in order to apply adequate screening procedures.