Total bilirubin may Predict Mortality in maintenance hemodialysis Patients: Study

The investigation also explored whether the predictive strength of bilirubin varied by age. Findings indicated that the association between bilirubin levels and mortality appeared stronger in non-elderly hemodialysis patients. This pattern suggests that younger individuals on long-term dialysis may be more physiologically sensitive to bilirubin-related pathways or that bilirubin may better capture risk in patients who have fewer competing comorbidities. While the biological mechanisms remain to be clarified, the researchers proposed that oxidative balance and inflammatory load—both reflected in bilirubin physiology—may play a larger role in survival outcomes among younger MHD patients.

The authors concluded that total bilirubin could serve as a useful and accessible biomarker for risk stratification in maintenance hemodialysis. They recommended future prospective studies to validate these findings and to determine whether monitoring bilirubin trends could support clinical decision-making or early intervention strategies. Because bilirubin measurement is already part of standard biochemical testing, integrating it into mortality risk assessments may be practical and immediately applicable across dialysis centers.

Reference:

Zhao, Y., Liu, F., Chen, H., & Wu, X. (2025). Total bilirubin as a predictor of all-cause mortality in patients undergoing maintenance hemodialysis. BMC Nephrology. https://doi.org/10.1186/s12882-025-04621-2