Prognostic Value of Serum Albumin Changes Over Time in Elderly Adults Undergoing Hemodialysis

Villain, Cédric; Fouque, Denis; Genet, Leslie; Jean, G.; Kuentz, François; Lataillade, Dominique; Legrand, E; Moreau-Gaudry, Xavier; Écochard, René

doi:10.1111/jgs.14159

Cited by 5 publications

(5 citation statements)

References 8 publications

(9 reference statements)

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“…Changes in sodium chloride levels induce changes in albumin synthesis and catabolism, which influence the inflammatory and nutritional status of patients on MHD. [ 12 , 13 ] Li et al [ 17 ] demonstrated that low Salb was associated with functional falls and independently increased the risk of death among elderly adults on HD. Moreover, studies have shown that changes in nutrition affect albumin synthesis, whereas inflammation and hypoalbuminemia increase the rate of fractional albumin catabolism.…”

Section: Discussionmentioning

confidence: 99%

“…Hypoalbuminemia is a marker of malnutrition–inflammation complex syndrome (MICS). Changes in sodium chloride levels induce changes in albumin synthesis and catabolism, which influence the inflammatory and nutritional status of patients on MHD [12,13] . Li et al [17] demonstrated that low Salb was associated with functional falls and independently increased the risk of death among elderly adults on HD.…”

Section: Discussionmentioning

confidence: 99%

“…There is conflicting evidence on the role of serum albumin (Salb) as an independent predictor of mortality among patients on MHD. Although previous studies have demonstrated that low Salb levels are associated with a high risk of mortality among patients receiving dialysis, [9–11] another study also demonstrated that baseline Salb levels of >3.8 g/dL are associated with a great risk of mortality [12] …”

Section: Introductionmentioning

confidence: 95%

“…Although previous studies have demonstrated that low Salb levels are associated with a high risk of mortality among patients receiving dialysis, [ 9 – 11 ] another study also demonstrated that baseline Salb levels of >3.8 g/dL are associated with a great risk of mortality. [ 12 ]…”

Section: Introductionmentioning

confidence: 99%

“…Although previous studies have demonstrated that low Salb levels are associated with a high risk of mortality among patients receiving dialysis, [9][10][11] another study also demonstrated that baseline Salb levels of >3.8 g/dL are associated with a great risk of mortality. [12] This study examined the effect of Salb levels on all-cause and cardiovascular-related mortality among patients on MHD to identify strategies for the reduction of the risk of mortality.…”

Section: Introductionmentioning

confidence: 99%

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Impact of serum albumin level and variability on short-term cardiovascular-related and all-cause mortality in patients on maintenance hemodialysis

et al. 2021

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Studies have shown that low serum albumin (Salb) levels are associated with a high risk of mortality among patients on maintenance hemodialysis (MHD); however, the impact of Salb variability on short-term cardiovascular mortality remains unclear. Herein, we investigated the association between Salb levels and Salb variability on short-term all-cause and cardiovascular-related mortality in patients on MHD.Eligible patients on MHD at Chongqing General Hospital between June 2017 and June 2020 were recruited in this study. Patients were grouped by Salb levels (normal Salb, ≥3.8 g/dL; low Salb, 3.4-3.8 g/dL; and lower Salb, 2-3.4 g/dL) and Salb variability (decreased, >5% loss; increased, >5% gain; and steady, 5% loss to 5% gain). Associations between Salb levels, Salb variability, and all-cause and cardiovascular-related mortality were analyzed using Cox regression models. A survival analysis was performed using the Kaplan-Meier analysis.We enrolled a total of 181 patients on MHD with an average age of 65 years (interquartile range [IQR], 53-75 years). The mean Salb level was 3.8 ± 0.6 g/dL (IQR 2.9-4.4 g/dL), and the median Salb variability was 2.6% per year (IQR, À4.1 to 6.5). Fifty-two (29%) patients died, including 31 (17%) patients who died due to cardiovascular-related causes. Compared with the other groups, the lower Salb group had higher all-cause mortality (P < .01). Cox regression analyses revealed that lower Salb levels and decreased Salb variability were independently associated with all-cause mortality (hazard ratio [HR] = 1.95, 95% confidence interval [CI] 1.103-3.452; HR = 2.245, 95% CI 1.084-4.650), whereas increased Salb variability was independently associated with cardiovascular-related mortality (HR = 2.919, 95% CI 1.178-7.234; P < .05).Lower Salb levels were an independent predictor of all-cause mortality in patients on MHD. Increased Salb variability was strongly associated with cardiovascular-related mortality in the same population, especially in the short-term and in patients with normal Salb levels. Significantly elevated Salb variability should be evaluated to reduce cardiovascular-related mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Impact of serum albumin level and variability on short-term cardiovascular-related and all-cause mortality in patients on maintenance hemodialysis

et al. 2021

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Clinical significance of hemodialysis quality of care indicators in very elderly patients with end stage kidney disease

et al. 2022

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Serum albumin measurement in nephrology: room for improvement

Lantman

Logt²,

Thelen

et al. 2020

Nephrology Dialysis Transplantation

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Serum albumin is a widely used biomarker in clinical nephrology. Serum albumin cut-off values are used to define disease, to predict outcome, and to guide patient care. The available commercial assays to measure serum albumin rely on different analytical principles, all with their own (analytical) specifications. This paper provides an overview of the different clinical applications of serum albumin measurements in nephrology, the (dis)advantages of the available assays and the estimates of the effects of the measurement uncertainty between different assays in clinical decision making. This paper concludes that harmonisation of serum albumin assay results are needed.

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Prognostic Value of Serum Albumin Changes Over Time in Elderly Adults Undergoing Hemodialysis

Cited by 5 publications

References 8 publications

Impact of serum albumin level and variability on short-term cardiovascular-related and all-cause mortality in patients on maintenance hemodialysis

Impact of serum albumin level and variability on short-term cardiovascular-related and all-cause mortality in patients on maintenance hemodialysis

Clinical significance of hemodialysis quality of care indicators in very elderly patients with end stage kidney disease

Serum albumin measurement in nephrology: room for improvement

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