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Butyrylcholinesterase level as an independent prognostic factor for overall survival in patients on maintenance hemodialysis: a single-center retrospective study

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Abstract

Background

We investigated whether butyrylcholinesterase (BChE) was independently related to the overall survival (OS) of patients on maintenance hemodialysis (MHD).

Methods

Baseline information, serum BChE level, and other laboratory data were collected from 295 patients on MHD in a single HD hospital in 2018. We retrospectively investigated the mortality of these patients after 38 months. We assessed the prognostic markers such as the Geriatric Nutritional Risk Index (GNRI), Erythropoiesis Resistance Index (ERI), and Simplified Creatinine Index (SCI) of each patient. The primary objective was to examine the impact of BChE on OS. The secondary objective included the designation of a risk score in predicting the OS.

Results

We evaluated 284 patients. The median value of the serum BChE level was 206 IU/L. Of 284 patients evaluated, eighty-six patients died; all had a higher ERI and a lower serum BChE level, SCI, and GNRI than the surviving patients. The optimal cutoff values of the BChE level, GNRI, ERI, and SCI for OS were 166 IU/L, 90.0, 8.00, and 20.6, respectively. The multivariate Cox regression analysis showed that the age, HD vintage, dialysis dose, GNRI of < 90.0, and serum BChE level of < 166 IU/L (hazard ratio, 2.03; P = 0.003) were the independent prognostic factors. We designed a risk score consisting of the GNRI and serum BChE level. The predictive value of our risk score was superior to that of GNRI alone.

Conclusion

The serum BChE level could be an independent prognostic factor for patients on MHD.

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Data availability statements

The datasets generated during and/or analyzed during this study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Sakiko Fujita, Akiko Kimura, Mieko Kawamura, Chizu Kawase, Kumiko Sato, and Masahiko Tezuka for their invaluable help with data collection. We would like to appreciate all staff in Oyokyo Kidney Research Institute Aomori Hospital for their valuable follow-up and Enago (www.enago.jp) for the English support.

Funding

No funding was received to assist with the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Urology, Oyokyo Kidney Research Institute Aomori Hospital, 101-1 kabe, Ishie, Aomori, 038-0003, Japan

    Ken Fukushi & Chikara Ohyama

  2. Department of Urology, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan

    Teppei Okamoto, Yusuke Ozaki, Kai Ozaki, Daichi Sasaki, Yuuki Miura, Yoshiharu Okuyama, Yoshimi Tanaka, Kengo Imanishi, Shingo Hatakeyama & Fumitada Saitoh

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  1. Ken Fukushi
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  2. Teppei Okamoto
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  3. Yusuke Ozaki
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Contributions

Conceptualization: TO; data curation: all authors; formal analysis: TO and KF; funding acquisition: not applicable; investigation: all authors; methodology: TO and KF; project administration: TO and SH; resources, software, supervision: CO validation: not applicable; visualization: not applicable; roles/writing—original draft: TO and KF; writing—review and editing: TO and KF; final approval of manuscript: all authors.

Corresponding author

Correspondence to Teppei Okamoto.

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Conflict of interests

All authors have no conflicts of interest to declare.

Ethical approval

This study was approved by the ethics committee of Hirosaki University Graduate School of Medicine (IRB number, Ken11H30001). The trial is registered in the UMIN Clinical Trials Registry UMIN000031200. All patients provided verbal informed consent to use data for this secondary post hoc analysis, which was recorded in their medical charts. The ethics committee of Hirosaki University School of Medicine permitted this procedure. All procedures that were performed in studies involving human participants were according to the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Fukushi, K., Okamoto, T., Ozaki, Y. et al. Butyrylcholinesterase level as an independent prognostic factor for overall survival in patients on maintenance hemodialysis: a single-center retrospective study. Clin Exp Nephrol 26, 190–197 (2022). https://doi.org/10.1007/s10157-021-02140-6

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  • DOI: https://doi.org/10.1007/s10157-021-02140-6

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