Serum hyaluronan concentrations predict survival in patients with chronic renal failure on maintenance haemodialysis

Malnutrition and wasting are common in chronic renal failure and are adverse prognostic features. The underlying mechanisms are complex and not fully understood. Hyaluronan is present in increased concentrations in chronic renal failure and may be associated with adverse features of chronic renal failure. We have investigated the relationship of this abnormality to long-term survival. Outcome of 81 patients of median of 5.6 years (3.9-6.8) after measurement of hyaluronan was determined. Survival analysis by the Cox regression model showed that increased concentrations of hyaluronan (P < 0.0001). There was also a weak but significant negative correlation between hyaluronan concentrations and serum albumin concentrations (rs = - 0.27, P = 0.02). We conclude that serum hyaluronan is a strong independent predictor of long-term survival in CRF may reflect abnormal connective tissue metabolism in this condition.