Baseline aspartate aminotransferase/alanine transaminase ratio is associated with 3-year mortality in peritoneal dialysis patients

Fasting venous blood samples were collected before PD initiation and sent to the Laboratory Center of West China Hospital for laboratory parameter measurements (including serum hemoglobin, albumin, magnesium, urea, calcium, phosphate, high-density lipoprotein cholesterol, AST, and ALT). Model 1, adjusted for age, sex, diastolic blood pressure, diabetes, cardiovascular disease, and respiratory disease; Model 2, Model 1 plus other laboratory results (hemoglobin, albumin, magnesium, calcium, and phosphate); Model 3, Model 2 plus PD-related parameters (weekly total Kt/V urea, weekly creatinine clearance, residual renal function, and peritoneal transport status). In the fully adjusted model (Model 3), only age (HR = 1.05, 95% CI: 1.03–1.07), albumin (HR = 0.94, 95% CI: 0.89–0.99), and AST/ALT (HR = 1.28, 95% CI: 1.10–1.48) were significantly associated with 3-year mortality. [...]we performed another multivariable analysis in competing risk analysis and obtained consistent findings: there was a significant relationship between AST/ALT and 3-year mortality (SHR = 1.26, 95% CI: 1.06–1.50 in the fully adjusted model). [...]our study identified a high baseline AST/ALT ratio as a prognostic factor for 3-year mortality in PD patients.