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Lower serum albumin before ESRD tied to poorer outcomes

27 Jun 2019

Lower serum albumin levels before end-stage renal disease (ESRD) increases the risk of all-cause, cardiovascular and infection-related death after ESRD, a recent study has shown.

Researchers retrospectively assessed 29,124 adults (mean age, 67±11 years; 2 percent female) with advanced chronic kidney disease progressing to ESRD. Pre-ESRD serum albumin measurements were obtained from patient records, and its association with post-ESRD outcomes was determined.

Pre-ESRD, those with higher baseline serum albumin levels showed further increases, while those with lower starting concentrations displayed further declines; those with the lowest levels (<2.8 g/dL) had the steepest declines.

In the first 12 months after the transition to ESRD, 6,236 deaths were reported, resulting in a crude mortality rate of 25.6 deaths per 100 person-years. On top of this, 468 patients (2 percent) received transplants and 2,027 (7 percent) were lost to follow-up.

Participants who had serum albumin concentrations <2.8 g/dL were twice as likely to die as those with levels 4.0 g/dL (hazard ratio [HR], 2.07, 95 percent CI, 1.87–2.28). Hypoalbuminaemia (<3.5 g/dL) had the same effect across all subgroups of clinical characteristics and laboratory measurements.

Having low baseline albumin (<2.8 g/dL) also significantly increased the risk of cardiovascular (HR, 2.10, 1.77–2.49) and infection-related (HR, 2.62, 1.85–3.72) mortality relative to those in the highest category of serum albumin. The same was true for hospitalization, which occurred significantly more frequently in those with lower baseline albumin (incidence rate ratio, 1.50, 1.45–1.56).

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Most Read Articles
4 days ago
Poor overall diet quality, particularly low intake of vegetable protein, appears to put elderly adults at greater risk of frailty, a recent study has found.
Pearl Toh, 15 Jul 2019
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from the large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
15 Jul 2019
Fluticasone, swallowed from a multidose inhaler, and oral viscous budesonide slurry have comparable efficacies as initial treatment for eosinophilic oesophagitis, a recent study has found.
2 days ago
Health-related quality of life (HRQoL) among patients with kidney stone is worse in those who are young and female than those who are older and male, according to a recent study. Non-Caucasian patients also have a lower HRQoL.