To investigate the relationship between prealbumin and mortality in patients undergoing maintenance hemodialysis (MHD).

Retrospective analysis of general conditions, biochemical indicators, and prognosis of patients undergoing MHD (dialysis age ≥3 months) in Beijing Civil Aviation General Hospital from January 2012 to June 2018. The data of dead patients were taken as the dead group, while data of the survivors were received as the survivor group. The data of the two groups were compared with t test, nonparametric test, and χ² test. Logistic regression analysis method was used to analyze the risk factors associated with all-cause death in MHD patients.

① 325 MHD patients were included in the study, whose mean age was 63.4±13.4 years, dialysis age was 64.0(41.5, 98.5)months. The survival group had 210 cases, and the death group had 115 cases. The primary causes of the death included infection (24%), cardiovascular diseases (17%), cerebrovascular diseases (16%), cachexia (12%), and tumors (10%), etc. ② The levels of albumin, prealbumin, serum creatinine, urea nitrogen, blood phosphorus, and intact parathyroid hormone of the dead group were all significantly lower than those in the survivor group (P<0.05). However, CRP (Z=5.824), dialysis age (Z=2.827), and patient age (t=7.672)were significantly higher than those of survivor group (P<0.05). There was no significant difference in the mortality between male and female (χ²=0.274, P>0.05), while the difference of mortality between diabetes patients and non-diabetes patients was significant (χ²=7.230, P<0.05). ③ Logistic regression analysis showed that patient age, dialysis age, diabetes, albumin, and prealbumin were independently associated with death in the MHD patients. Albumin (OR=0.854) and prealbumin (OR=0.983) were independent protective factors (P<0.05), while the patient age (OR=1.046), dialysis age (OR=1.012), and diabetes (OR=2.201)were independent risk factors (P<0.05). ④Prealbumin was positively associated with albumin (r=0.609, P<0.001), but prealbumin was positively associated with other nutritional indexes to a greater degree.

Prealbumin and albumin had independent protective effects on the motality of the MHD patients, which were crucial in predicting the death in the MHD patients.