Associations of CALLY, CLR, and CHR with all-cause mortality in patients receiving maintenance hemodialysis: a two-center retrospective cohort study - Summary - MDSpire
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Associations of CALLY, CLR, and CHR with all-cause mortality in patients receiving maintenance hemodialysis: a two-center retrospective cohort study
To evaluate the associations of the CALLY index, CLR, and CHR with all-cause mortality in patients receiving maintenance hemodialysis.
Approach:
Study Design: Retrospective two-center cohort study including adult patients undergoing maintenance hemodialysis at Shenzhen People’s Hospital and Huidong People’s Hospital, China.
Data Collection: Baseline data collected from January 2017 to October 2022, with follow-up until death or October 2023.
Statistical Analysis: CALLY, CLR, and CHR were analyzed using Cox proportional hazards models, Kaplan-Meier curves, restricted cubic splines, and sensitivity analyses.
Key Findings:
125 patients died during a median follow-up of 36.67 months (IQR, 20.01–52.80 months).
Each one-unit increase in ln CALLY was associated with lower all-cause mortality risk (HR, 0.85; 95% CI, 0.77-0.94; P = 0.002).
ln CLR and ln CHR were associated with higher mortality risk (HR, 1.19; 95% CI, 1.06-1.33; P = 0.003 and HR, 1.18; 95% CI, 1.07-1.31; P = 0.002).
Significant survival differences were observed across tertiles of the indices (log-rank P = 0.016, 0.012, and 0.044).
3-year AUCs for ln CALLY, ln CLR, and ln CHR were 0.603, 0.598, and 0.563 respectively.
Interpretation:
ln CALLY, ln CLR, and ln CHR were associated with all-cause mortality in MHD patients.
Limitations:
Retrospective design may introduce bias.
Data limited to two centers in China, affecting generalizability.
Conclusion:
CALLY, CLR, and CHR may serve as markers for prognostic risk stratification in MHD patients.
The approval was based on reduced proteinuria, and an ongoing trial is required to determine whether atacicept slows long-term kidney function decline.
