Hypoalbuminemia Within Two Postoperative Days Is an Independent Risk Factor for Acute Kidney Injury Following Living Donor Liver Transplantation

Sang, Bo-Hyun; Bang, Ji‐Yeon; Song, Jun-Gol; Hwang, Gyu‐Sam

doi:10.1097/ccm.0000000000001279

Cited by 75 publications

(82 citation statements)

References 35 publications

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“…Furthermore, ICU ( P = 0.006) and hospital ( P < 0.001) stays were prolonged in the low albumin group and overall mortality was also higher ( P = 0.02), making this one of the few studies retained from our literature review to report data associating serum albumin level with mortality. The findings of Sang et al[46] are consistent with an earlier, smaller retrospective study by Chen et al[44] in which multivariable analysis of 118 matched pairs of liver transplantation patients with/without postoperative renal injury demonstrated that preoperative hypoalbuminemia (≤ 3.5 g/dL) was strongly predictive of AKI within the first week after surgery. Similarly, Park et al[47] also identified by multivariate analysis that preoperative serum albumin < 3.5 g/dL was an independent, modifiable risk factor for AKI (RIFLE classification) in patients ( n = 538) undergoing LDLT.…”

Section: Transplant Surgerysupporting

confidence: 78%

“…The largest of the three retrospective, observational studies assessing hypoalbuminemia in liver transplantation was a propensity score analysis of 998 consecutive living donor liver transplantation (LDLT) patients in a single center[46]. This analysis aimed to ascertain the influence of early postoperative serum albumin level on subsequent development of AKI.…”

Section: Transplant Surgerymentioning

confidence: 99%

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Causal relationship between hypoalbuminemia and acute kidney injury

Wiedermann¹,

Wiedermann²,

Joannidis³

2017

WJN

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Our meta-analysis published in 2010 provided evidence that low levels of serum albumin (hypoalbuminemia) are a significant independent predictor of acute kidney injury (AKI) and death following AKI. Since then, a large volume of additional data from observational clinical studies has been published further evaluating the relationship between serum albumin and AKI occurrence. This is an updated review of the literature to re-evaluate the hypothesis that hypoalbuminemia is independently associated with increased AKI risk. Eligible studies published from September 2009 to December 2016 were sought in PubMed (MEDLINE) and forty-three were retained, the great majority being retrospective observational cohort studies. These included a total of about 68000 subjects across a diverse range of settings, predominantly cardiac surgery and acute coronary interventions, infectious diseases, transplant surgery, and cancer. Appraisal of this latest data set served to conclusively corroborate and confirm our earlier hypothesis that lower serum albumin is an independent predictor both of AKI and death after AKI, across a range of clinical scenarios. The body of evidence indicates that hypoalbuminemia may causally contribute to development of AKI. Furthermore, administration of human albumin solution has the potential to prevent AKI; a randomized, controlled study provides evidence that correcting hypoalbuminemia may be renal-protective. Therefore, measurement of serum albumin to diagnose hypoalbuminemia may help identify high-risk patients who may benefit from treatment with exogenous human albumin. Multi-center, prospective, randomized, interventional studies are warranted, along with basic research to define the mechanisms through which albumin affords nephroprotection.

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Section: Transplant Surgerysupporting

confidence: 78%

Section: Transplant Surgerymentioning

confidence: 99%

Causal relationship between hypoalbuminemia and acute kidney injury

Wiedermann¹,

Wiedermann²,

Joannidis³

2017

WJN

View full text Add to dashboard Cite

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“…Hypoalbuminemia is a predictor of mortality in patients with various illnesses [37][38][39][40][41]. Our study was the first to suggest the association between hypoalbuminemia and the mortality of IPFD.…”

Section: Discussionmentioning

confidence: 73%

Pulmonary Fungal Diseases in Immunocompetent Hosts: A Single-Center Retrospective Analysis of 35 Subjects

et al. 2016

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“…Baseline characteristics included age, sex, body mass index, American Society of Anesthesiologists (ASA) grade, comorbidities, and surgical indication. Laboratory data included hemoglobin, preoperative CRP and albumin, CRP on POD 3 [7], and albumin on POD 3 [13]. Intraoperative data included operation time, type of surgery, surgical approach (open vs laparoscopy), stoma creation, intraoperative blood transfusion, and estimated blood loss during surgery.…”

Section: Methodsmentioning

confidence: 99%

“…Surgical site complications included superficial incisional, deep incisional, or organ/space SSIs. For evaluation, CAR was defined as (CRP level on POD 3)/(ALB level on POD 3) [1, 13, 15]. The CAR cutoff values were determined using receiver operating characteristic (ROC) curve analysis [11].…”

Section: Methodsmentioning

confidence: 99%

Diagnostic accuracy of the postoperative ratio of C-reactive protein to albumin for complications after colorectal surgery

Cao

Wang

et al. 2017

World J Surg Onc

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BackgroundThe ratio of C-reactive protein to albumin, as a novel inflammation-based prognostic score, is associated with outcomes in cancer and septic patients. The diagnostic accuracy of the CRP/albumin ratio has not been assessed in colorectal surgery for postoperative complications.MethodsA total of 359 patients undergoing major colorectal surgery between 2012 and 2015 were eligible for this study. Uni- and multivariate analyses were performed to identify risk factors for postoperative complications. Receiver operating characteristic curves were developed to examine the cutoff values and diagnostic accuracy of the CRP/albumin ratio and postoperative CRP levels.ResultsAmong all the patients, 139 (38.7%) were reported to have postoperative complications. The CRP/albumin ratio was an independent risk factor for complications (OR 4.413; 95% CI 2.463–7.906; P < 0.001), and the cutoff value was 2.2, which had a higher area under the curve compared to CRP on postoperative day 3 (AUC 0.779 vs 0.756). The CRP/albumin ratio also had a higher positive predictive value than CRP levels on postoperative day 3. Patients with CRP/albumin ≥2.2 suffered more postoperative complications (60.8% vs 18.6%, P < 0.001), longer postoperative stays (10 (4–71) vs 7 (3–78) days, P < 0.001), and increased surgical site infections (SSIs) (21.1% vs 4.8%, P < 0.001) than those with CRP/albumin <2.2.ConclusionsThe ratio of C-reactive protein to albumin could help to identify patients who have a high probability of postoperative complications, and the ratio has higher diagnostic accuracy than C-reactive protein alone for postoperative complications in colorectal surgery.

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Hypoalbuminemia Within Two Postoperative Days Is an Independent Risk Factor for Acute Kidney Injury Following Living Donor Liver Transplantation

Abstract: Early postoperative hypoalbuminemia is an independent risk factor for acute kidney injury, and postoperative acute kidney injury is related to postoperative ICU stay and overall mortality after living donor liver transplantation.

Cited by 75 publications

References 35 publications

Causal relationship between hypoalbuminemia and acute kidney injury

Causal relationship between hypoalbuminemia and acute kidney injury

Pulmonary Fungal Diseases in Immunocompetent Hosts: A Single-Center Retrospective Analysis of 35 Subjects

Diagnostic accuracy of the postoperative ratio of C-reactive protein to albumin for complications after colorectal surgery

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