Non-linear relationship between basal serum albumin concentration and cardiac arrest in critically ill patients with end-stage renal disease: a cross-sectional study

Zeng, Yongqin; Qin, Zuoan; Guo, Ziwei; Li, Bo; Yu, Haijing; Chen, Ruixue; Tang, Ying-Qian; Hu, K.; Guan, Cheng-Jing; Yan, Rui

doi:10.1136/bmjopen-2021-051721

Cited by 3 publications

(3 citation statements)

References 29 publications

(52 reference statements)

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“…On another note, the association between higher levels of albumin and decreased risk of cardiac arrest in dialysis patients has been previously described [20]. Albumin levels in this population are typically low due to reduced albumin synthesis in the setting of a chronic inflammatory state, albumin loss in the urine and protein loss from dialysis itself (20).…”

Section: Rapa Et Al Emphasized the Role Of Inflammation And Oxidative...mentioning

confidence: 89%

“…Albumin levels in this population are typically low due to reduced albumin synthesis in the setting of a chronic inflammatory state, albumin loss in the urine and protein loss from dialysis itself (20). Albumin contributes to uremic toxin removal and has anticoagulant/antithrombotic effects so lower levels of this marker is unsurprisingly associated with higher risk of cardiac arrest [20].…”

Section: Rapa Et Al Emphasized the Role Of Inflammation And Oxidative...mentioning

confidence: 99%

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Untitled

2023

NRT

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Cardiac arrest represents a significant cause of mortality among patients with End-Stage Renal Disease (ESRD) undergoing renal replacement therapy. This review aimed to synthesize current knowledge on the risk, mechanisms, outcomes and preventative measures for cardiac arrest in this vulnerable population. We conducted a comprehensive literature search in PubMed, identifying both prospective and retrospective studies that reported on cardiac arrest in adult ESRD patients on dialysis. The analysis included variables such as demographics, traditional and non-traditional risk factors and mechanisms of cardiac arrest and prevention strategies. Our review article revealed that cardiovascular disease is a significant burden in ESRD, with cardiac arrest accounting for a significant proportion of mortality. Traditional risk factors included hypertension, diabetes, age, male sex and smoking. Non-traditional risk factors include duration of dialysis treatment, hypotension, inflammation, oxidative stress, mineral bone disorders, electrolyte imbalances, anemia and arrhythmias. Dialysis variables, such as timing, temperature and dialysate composition, were also implicated. We identified several preventative measures, including managing traditional cardiovascular risk factors, modifying dialysis prescriptions, regular cardiac monitoring, consideration of alternative dialysis modalities and medications and optimization of electrolytes and anemia. Our findings underscore the necessity for future research to further understand the intricate relationship between cardiac arrest and hemodialysis, aiming to refine and enhance preventative strategies to improve patient outcomes.

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Section: Rapa Et Al Emphasized the Role Of Inflammation And Oxidative...mentioning

confidence: 89%

Section: Rapa Et Al Emphasized the Role Of Inflammation And Oxidative...mentioning

confidence: 99%

Untitled

2023

NRT

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“…Albumin is synthesized by the liver and has important physiological functions, such as anti-inflammatory and antioxidant activities, scavenging free radicals, and maintaining plasma osmolality. When the body is infected or hit, the consumption of albumin increases, and studies have shown that lower albumin levels are associated with increased mortality in patients with various diseases [ 8 , 9 , 10 ]. In addition, multiple studies have shown that elevated LDH and decreased albumin levels are associated with poor outcomes in CA patients [ 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Correlation between Lactate Dehydrogenase to Albumin Ratio and the Prognosis of Patients with Cardiac Arrest

Ye,

Lu,

Yuan

et al. 2024

Rev. Cardiovasc. Med.

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Background: Cardiac arrest (CA) is a common event in the intensive care unit (ICU), which seriously threatens the prognosis of patients. Therefore, it is crucial to determine a simple and effective clinical indicator to judge the prognosis of patients after a CA for later treatments. The purpose of this study was to investigate the relationship between the lactate dehydrogenase to albumin ratio (LAR) and the prognosis of patients after a CA. Methods: The clinical data of participants was obtained from the Medical Information Mart for Intensive Care IV (MIMIC-IV, v2.0; 2008 to 2019). According to the 30-day prognosis, patients were divided into a survivors group (n = 216) and a non-survivors group (n = 304). The optimal LAR threshold was determined using restricted cubic spline (RCS), which divided patients into a high LAR group ( 15.50, n = 257) and a low LAR group ( 15.50, n = 263). The ICU hospitalization and 30-day accumulative survival curves of the two groups were plotted following the Kaplan–Meier survival analysis. Multivariate Cox regression was used to analyze the relationship between the LAR and the prognosis of CA patients. Receiver operating characteristic (ROC) curves were drawn to evaluate the predictive efficacy of the LAR on 30-day all-cause mortality, and sensitivity analysis was used to check the reliability of the findings. Results: A total of 520 patients with CA were enrolled and the 30-day mortality was 58.46%. The LAR in the non-survivors group was higher than in the survivors group. The RCS showed a linear trend relationship between the LAR and the mortality risk in patients during their ICU stay and 30 days; moreover, as the LAR increased, so did the risk of mortality. The Kaplan–Meier survival curve showed that compared with the low LAR group, the cumulative survival rates of ICU hospitalization and 30 days were lower in the high LAR group among CA patients ( p 0.001). Multivariate Cox regression analysis showed that an elevated LAR ( 15.50) was an independent risk factor for mortality during ICU stay and 30 days ( p 0.005). ROC analysis suggested that the LAR was superior to the sequential organ failure assessment (SOFA) score in predicting the 30-day all-cause mortality in CA patients (area under the curve (AUC) = 0.676, 95% confidence interval [CI]: 0.629–0.723). To verify the reliability of our findings, we performed sensitivity analyses and found that the findings were reliable. Conclusions: An elevated LAR might be a predictor of mortality in patients following a CA during ICU hospitalization and 30 days, thereby it can be used to provide a reference for the clinical management of these patients.

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Effects and Clinical Value of Peritoneal Dialysis on Water and Water Balance, Adverse Reactions, Quality of Life, and Clinical Prognosis in Patients with Decompensated Chronic Nephropathy: A Systematic Review and Meta-Analysis

Wang

Zhang

Sun

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. To systematically evaluate the effects of peritoneal dialysis and hemodialysis on renal function and quality of life in patients with end-stage renal disease. An evidence-based medical rationale would be provided for peritoneal dialysis or hemodialysis treatment in patients with end-stage renal disease. Methods. The PubMed, EMBASE, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure (CNKI), China VIP Database, Wanfang, and China Biomedical Literature Database (CBM) online databases were searched. Comparisons on the effects of peritoneal dialysis on renal function and quality of life were taken between patients with end-stage renal disease (RD). The data were extracted independently by two researchers. The bias-risk-included literatures were assessed according to the Cochrane manual 5.1.0 standard. RevMan 5.4 statistical software was used to analyze the collected data via meta-analysis. Results. Seven RCT articles were finally included. A total of 745 samples were analyzed via meta-analysis. The obvious heterogeneities of serum creatinine (Scr) and blood urea nitrogen (BUN) were discovered ( P < 0.00001 ) in the selective investigations. According to the results of this analysis, it was indicated that the renal function of patients with end-stage renal disease treated by peritoneal dialysis was significantly better than that of hemodialysis. According to the meta-analysis, there was obvious heterogeneity of life quality among the included research data. It was indicated that the score of quality of life of patients with end-stage renal disease treated by peritoneal dialysis was significantly better than that of hemodialysis. Conclusion. Compared with hemodialysis in the treatment of end-stage renal disease, the renal function and quality of life of patients with peritoneal dialysis are better than those of hemodialysis. More further studies and follow-up with higher methodological quality and longer intervention time are still needed for further verification.

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Non-linear relationship between basal serum albumin concentration and cardiac arrest in critically ill patients with end-stage renal disease: a cross-sectional study

Cited by 3 publications

References 29 publications

Untitled

Untitled

Correlation between Lactate Dehydrogenase to Albumin Ratio and the Prognosis of Patients with Cardiac Arrest

Effects and Clinical Value of Peritoneal Dialysis on Water and Water Balance, Adverse Reactions, Quality of Life, and Clinical Prognosis in Patients with Decompensated Chronic Nephropathy: A Systematic Review and Meta-Analysis

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