Abstract: Objective To investigate C-reactive protein (CRP) combined with serum albumin (ALB) in the prediction of all-cause mortality in maintenance hemodialysis (MHD) patients. Methods A total of 314 MHD cases treated in the period from Jan. 2012 to Dec. 2016 in the Hemodialysis Center of Civil Aviation General Hospital were registered in Beijing Hemodialysis Quality Control and Improvement Center Network. Their general information, laboratory results and outcomes were recruited. Results In the 314 MHD cases, the average age was 63.32±13.57 years, the dialysis vintage was 65.00 (43.75, 100.00) months, and 88 patients
(28.03%) died. CRP was positive (≥3 mg/L) in 157 cases (50.00%) and ALB was positive (＜38 g/L) in 126 cases (40.13%). According to CRP and ALB values, patients were divided into negative CRP and negative ALB group (n=109), positive CRP or positive ALB group (n=127), and positive CRP and positive ALB group (n=78); Statistical difference in all-cause mortality was found between the 3 groups (13.76%, 26.77% and 50.00% respectively; χ2=29.766, P＜0.001). Kaplan-Meier method showed that all- cause mortality was higher in patients with positive CRP and positive ALB than in patients with positive CRP or positive ALB, and was higher in patients with positive CRP or positive ALB than in patients with negative CRP and negative ALB (χ2=39.380, P＜0.001). Multivariate Cox regression showed that age (HR=1.022, 95% CI 1.001～1.045, P=0.044) and diabetes (HR=1.665, 95% CI 1.068～2.596, P=0.024) were the independent risk factors for allcause mortality, and serum creatinine was the independent protective factor (HR=0.998, 95% CI 0.997-0.999, P=0.005). If positive CRP or positive ALB group was used as a reference, positive CRP combined with positive ALB was the independent risk factor for all-cause mortality (HR=1.709, 95% CI 1.027～2.843, P=0.039). Conclusion C-reactive protein combined with serum albumin is closely related to all-cause mortality, i.e., positive CRP combined with positive ALB is the independent risk factor for all-cause mortality in MHD patients.

Key words: Hemodialysis, C-reactive protein, Serum albumin, mortality