Prognostic Significance of the Albumin to Fibrinogen Ratio in Peritoneal Dialysis Patients

Abstract

BackgroundAlbumin to fibrinogen ratio (AFR) is a demonstrated predictor of mortality in various diseases. The aim of this study was to evaluate the prognostic value of AFR to predict mortality in peritoneal dialysis (PD) patients.MethodsWe retrospectively analyzed 212 incident PD patients from January 2010 to December 2017 and followed them until December 2019. We used receiver operating curve (ROC) analysis to determine the optimal cut-off point for AFR at baseline to predict overall and cardiovascular mortality during the follow-up period. Kaplan-Meier curve and Cox regression analysis were applied to evaluate the association between AFR and all-cause and cardiovascular mortality.ResultsThe optimal threshold for AFR to predict mortality was 8.48. A low AFR was strongly correlated with worse all-cause and cardiovascular mortality in PD patients. Multivariate analysis revealed that elevated AFR was an independent marker predicting reduced all-cause and cardiovascular mortality (HR 2.41, 95% CI 1.11–5.22, P = 0.026; and HR 2.18, 95% CI 1.21–3.95, P = 0.010, respectively).ConclusionsPatients with a high AFR had reduced all-cause and cardiovascular mortality. AFR is a potential prognostic biomarker in PD patients.

Plasma fibrinogen: a driver of left ventricular remodeling in patients undergoing peritoneal dialysis and its related risk factors

“…Xia et al. found that patients undergoing PD with a high albumin to fibrinogen ratio had reduced all-cause and cardiovascular mortality [ 7 ]. In our study, we found that plasma fibrinogen was an independent risk factor for LV remodeling in patients undergoing PD.…”

“…According to statistics, the prevalence of LVH in patients on hemodialysis or PD is approximately 75% [ 5 ]. Recently, plasma fibrinogen level has been proven to be significantly associated with an increased risk of cardiovascular events and all-cause mortality in patients on PD [ 6 , 7 ]. Of note hyperfibrinogenemia is common among patients treated with dialysis, especially in those on PD.…”