The Level of Serum Albumin Is Associated with Renal Prognosis in Patients with Diabetic Nephropathy

Abstract

Objective. Although hypoalbuminemia is frequently found in most patients with diabetic nephropathy (DN), its relationship to the severity and progression of DN remains largely unknown. Our aim was to investigate the association between the serum albumin levels and clinicopathological features and renal outcomes in patients with type 2 diabetes mellitus (T2DM) and biopsy-proven DN. Materials and Methods. A total of 188 patients with T2DM and biopsy-proven DN followed up for at least one year were enrolled. The patients were divided into four groups based on the albumin levels: normal group: ≥35 g/L (n=87); mild group: 30-35 g/L (n=34); moderate group: 25-30 g/L (n=36); and severe group: <25 g/L (n=31). The renal outcome was defined by progression to end-stage renal disease. The impact of the serum albumin level on renal survival was estimated using Cox regression analysis. Results. Among the cases, the serum albumin level had a significant correlation with proteinuria, renal function, and glomerular lesions. A multivariate Cox regression analysis indicated that the severity of hypoalbuminemia remained significantly associated with an adverse renal outcome, independent of clinical and histopathological features. In reference to the normal group, the risk of progression to ESRD increased such that the hazard ratio (HR) for the mild group was 2.09 (95% CI, 0.67-6.56, p=0.205), 6.20 (95% CI, 1.95-19.76, p=0.002) for the moderate group, and 7.37 (95% CI, 1.24-43.83, p=0.028) for the severe group. Conclusions. These findings suggested that hypoalbuminemia was associated with a poorer renal prognosis in patients with T2DM and DN.

Metabolome modulatory effects of Kigelia africana (Lam.) Benth. fruit extracts on oxidative stress, hyperlipidaemic biomarkers in STZ-induced diabetic rats and antidiabetic effects in 3T3 L1 adipocytes

“…Normally, an assault to the body of diabetic patients causes a reduction in the concentrations of total protein and albumin alongside increase in total bilirubin concentration. [62] The results of this study agreed with the works of Iwasaki et al, [63] Gonz alez-Pacheco et al, [64] Zhang et al [65] and Zhu et al [66] The high concentration of bilirubin in diabetic group of experimental rats as found in our study shows that a damage to the liver leads to the release of bilirubin into the bloodstream causing the levels to increase with reduction in the level of albumin and total protein. The impact of K. africana will be to normalize the levels of these biochemical biomarkers.…”

Association of Baseline Concentrations of Liver Function Tests and Full Blood Count Indices with Annual eGFR Decline and Renal Outcomes in Aboriginal and Torres Strait Islander People: The eGFR Follow- Up Study

“…As expected, and found in many studies, serum albumin concentrations were inversely associated with decline in eGFR and high risk of adverse renal outcomes [34][35][36][37]. Similarly, the inverse relationship between haemoglobin and decline in eGFR and poor renal outcomes is expected.…”

Predictive factors of rapid linear renal progression and mortality in patients with chronic kidney disease

“…Studies have shown that younger age [17], dyslipidaemia [18], lower albumin [19], lower Hb [20] and proteinuria [21] are associated with CKD progression and all these factors were predictive of patients having rapid linear progression in our analysis. The observation of younger patients at more at risk of progression may be due to the underlying age differences in CKD aetiology [22].…”