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Year : 2021  |  Volume : 31  |  Issue : 3  |  Page : 212--217

The Gamma Gap Predicts All-Cause Mortality in Chronic Dialysis Patients

Petar J Avramovski1, Aleksandar Petlichkovski2, Maja Avramovska3, Biljana Ilkovska4, Kosta Sotiroski5, Zorica Nikleski6, Emilija Sikole7 
1 Docent in Faculty of Veterinary Medicine-Bitola, St. Clement of Ohrid University of Bitola; Primarius, Specialist of Internal Medicine, Department of Ultrasonography, Clinical Hospital Dr Trifun Panovski, Partizanska b.b., North Macedonia, Bitola, North Macedonia
2 Professor of Human Genetics and Immunobiology, Director of Institute for Immunobiology and Human Genetics, Faculty of Medicine Skopje, University Ss. Cyril and Methodius University, Skopje, North Macedonia
3 Specialist of Obstetrics and Gynecology, Clinical Hospital Dr Trifun Panovski, Partizanska b.b, North Macedonia
4 Specialist of Clinical Biochemistry, Clinical Hospital Dr Trifun Panovski, Partizanska b.b., Bitola, North Macedonia
5 Professor on Statistics at Faculty of Economics-Prilep, St. Clement of Ohrid University of Bitola, North Macedonia
6 Master of Public Health, Advanced Torrens University Sydney, Australia
7 Institute of Preclinical and Clinical Pharmacology with Toxicology, Faculty of Medicine Skopje, University “SS. Cyril and Methodius”, - Skopje, North Macedonia

Correspondence Address:
Prof. Petar J Avramovski
Ivan Milutinovik No. 37/4-26, 7000 Bitola
North Macedonia

Introduction: The gamma gap (γ-gap) represents the total serum protein concentration minus the albumin concentration. The main aim of this study was to test whether the gamma gap is a predictor of mortality and whether it is associated with other predictors of mortality in chronic hemodialysis patients (CHPs). Materials and Methods: We studied a cohort of 100 CHPs with a mean age of 59 ± 12.3 years with duration of dialysis 6.5 ± 4.7 years. Serum proteins were determined by electrophoresis. The association of the gamma gap with serum C-reactive protein (CRP), fibrinogen and albumin concentration was evaluated for correlation. Cox regression analysis was used to identify the predictors of mortality. Results: The γ-gap correlates positively with CRP (r = 0.247, P = 0.013) and fibrinogen (r = 0.239, P = 0.016), and inversely with albumin (r = -0.430, P < 0.0001). The regression coefficients (b) and Exp (b) hazard ratio coefficients of covariates in Cox-regression survival analysis in all-cause outcomes were: b = 0.1486, Exp (b) = 1.1602 (P < 0.0001); b = 0.0655, Exp (b) = 1.0677 (P < 0.0015) and b = -0.118, Exp (b) = 0.8887 (P < 0.0009), for γ-gap, CRP and albumin, respectively. Conclusions: In patients on chronic hemodialysis, the gamma gap, along with serum albumin and CRP levels, is an independent predictor of mortality. Gamma gap levels correlate directly with serum CRP and fibrinogen levels and inversely with serum albumin levels.

How to cite this article:
Avramovski PJ, Petlichkovski A, Avramovska M, Ilkovska B, Sotiroski K, Nikleski Z, Sikole E. The Gamma Gap Predicts All-Cause Mortality in Chronic Dialysis Patients.Indian J Nephrol 2021;31:212-217

How to cite this URL:
Avramovski PJ, Petlichkovski A, Avramovska M, Ilkovska B, Sotiroski K, Nikleski Z, Sikole E. The Gamma Gap Predicts All-Cause Mortality in Chronic Dialysis Patients. Indian J Nephrol [serial online] 2021 [cited 2021 Jul 25 ];31:212-217
Available from: https://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2021;volume=31;issue=3;spage=212;epage=217;aulast=Avramovski;type=0