NEPHROLOGY - ORIGINAL PAPER Endothelial dysfunction, inflammation and malnutrition markers as predictors of mortality in dialysis patients: multimarker approach Aleksandra M. Ignjatovic ´ • Tatjana P. Cvetkovic ´ • Radmila M. Pavlovic ´ • Vidojko M. Ðord¯evic ´ • Zoran G. Milos ˇevic ´ • Vidosava B. Ðord¯evic ´ • Dus ˇica D. Pavlovic ´ • Ivana R. Stojanovic ´ • Dragan Bogdanovic ´ Received: 11 February 2013 / Accepted: 5 April 2013 Ó Springer Science+Business Media Dordrecht 2013 Abstract Backgrounds Cardiovascular disease is reported to be major cause of mortality in dialysis patients. Multimarker approach is new approach in risk strat- ification. Creating a common predictive value, many different pathophysiological components are covered. The aim of this study was to examine the combined predictive value of markers of endothelial dysfunction (ADMA), inflammation (CRP, SAA) and malnutrition (albumin) in dialysis patients. Methods In this prospective 3-year follow-up study, 153 prevalent patients (105 males and 48 females) on hemodialysis were included. ADMA were measured by HPLC; CRP and SAA were measured using immunonephelometric assays. Albumins were mea- sured by the use of standard methods on the automated analyzer. The patients were stratified into five groups based on the presence of 1, 2, and 3 or more risk markers, respectively, namely high ADMA (C0.49 lmol/L), high CRP (C6.0 mg/L), high SAA (C7.6 mg/L) and low albumin ( \ 30.3 g/L). Results The patients with 1, 2, 3 or more risk markers had an adjusted hazard ratio (HR) of 2.419 (0.728–8.034), 6.720 (2.100–21.503), 10.455 (3.193–24.227), respectively, for mortality, compared to those without risk markers. The patients with 1, 2, 3 or more risk markers had an adjusted HR of 1.838 (0.307–11.006), 9.924 (2.052–28.003), 14.823 (0.2.962–34.189), respectively, for cardiovascular mortality than those without risk markers. Conclusions The results of this study demonstrate that the common predictive value of several markers is A. M. Ignjatovic ´(&) Á Z. G. Milos ˇevic ´ Department of Medical Statistics, Faculty of Medicine Nis ˇ, University of Nis ˇ, Boulevard Zorana Djindjica 81, 18000 Nis, Serbia e-mail: drsalea@yahoo.com; aleksandra.ignjatovic@live.com A. M. Ignjatovic ´ Á R. M. Pavlovic ´ Faculty of Medicine Nis ˇ, Research Centre for Biomedicine, University of Nis ˇ, Boulevard Zorana Djindjica 81, 18000 Nis, Serbia T. P. Cvetkovic ´ Á V. B. Ðord¯evic ´ Á D. D. Pavlovic ´ Á I. R. Stojanovic ´ Institute of Biochemistry, Faculty of Medicine Nis ˇ, University of Nis ˇ, Boulevard Zorana Djindjica 81, 18000 Nis, Serbia T. P. Cvetkovic ´ Á V. M. Ðord¯evic ´ Clinic of Nephrology, Clinical Centre Nis ˇ, Boulevard Zorana Djindjica 48, 18000 Nis, Serbia D. Bogdanovic ´ Department of Biomedical Sciences, State University of Novi Pazar, Vuka Karadzica bb, 36300 Novi Pazar, Serbia 123 Int Urol Nephrol DOI 10.1007/s11255-013-0439-6