Variations in Serum Albumin Levels Over Time in Patients Treated With Conventional Hemodialysis or Expanded Hemodialysis: A Cohort Study

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Hemodialysis International Pub Date : 2025-04-29 DOI:10.1111/hdi.13232

Juan C. Castillo, Jasmin Vesga, Angela Rivera, Peter Rutherford, Ricardo Sanchez, Henry Oliveros, Bengt Lindholm, Mauricio Sanabria, the Colombian Registry of Expanded Hemodialysis Investigators

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引用次数: 0

Abstract

Introduction

Hypoalbuminemia is a well-established risk factor for mortality in chronic hemodialysis (HD) patients. To evaluate the association of time-varying serum albumin with the type of dialyzer, we analyzed serum albumin over time in two cohorts of HD patients, one receiving HDx therapy enabled by the Theranova dialyzer and the other conventional HD with high-flux dialyzer (HF-HD).

Methods

In this cohort study, 1092 prevalent adult HD patients (mean age 61 years; 62% men; 42% had diabetes; 19% had cardiovascular disease) at Renal Care Services Colombia undergoing either HDx therapy enabled by Theranova dialyzer (n = 559) or HF-HD (n = 533) were enrolled between September 1, 2017, and November 30, 2017, and then underwent repeated measurements of serum albumin for up to 48 months. Sociodemographic and clinical, and laboratory characteristics at baseline were recorded, and a repeated-measures analysis of variance (ANOVA) was conducted to examine differences in means of serum albumin at different time points. To evaluate the association between dialysis membrane and albumin levels during the follow-up, a linear panel regression analysis was performed, allowing control for imbalances in the cohorts of baseline clinical and demographic variables, as well as the time-dependent variables.

Results

Mean albumin concentration remained above 3.8 g/dL and did not differ over time between HDx and HF-HD (p = 0.789). No association (p = 0.208) between serum albumin levels varying over time and the use of the Theranova dialyzer was found in the linear panel regression model. However, serum albumin was linked to both inflammatory and nutritional markers, including C-reactive protein, ratio of platelets to lymphocytes, and protein-energy wasting.

Conclusion

Variations in serum albumin levels over time were associated with protein-energy wasting, inflammation, high age, vascular access, and hospitalizations, but not with the type of dialyzer.

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查看原文本刊更多论文

常规血液透析或扩展血液透析患者血清白蛋白水平随时间的变化：一项队列研究。

低白蛋白血症是慢性血液透析（HD）患者死亡的一个公认的危险因素。为了评估时变血清白蛋白与透析器类型的关系，我们分析了两组HD患者的血清白蛋白随时间的变化，一组接受Theranova透析器支持的HDx治疗，另一组接受高通量透析器（HF-HD）的传统HD。方法：在这项队列研究中，1092例流行的成人HD患者(平均年龄61岁；男性62%;42%患有糖尿病；在2017年9月1日至2017年11月30日期间，在哥伦比亚肾脏护理服务中心接受了由Theranova透析器支持的HDx治疗（n = 559）或HF-HD (n = 533)，然后进行了长达48个月的血清白蛋白重复测量。记录基线时的社会人口学、临床和实验室特征，并进行重复测量方差分析（ANOVA）来检查不同时间点血清白蛋白均值的差异。为了评估随访期间透析膜和白蛋白水平之间的关系，进行了线性面板回归分析，允许控制基线临床和人口统计学变量队列中的不平衡，以及时间相关变量。结果：平均白蛋白浓度保持在3.8 g/dL以上，在HDx和HF-HD之间没有随时间的差异（p = 0.789）。在线性面板回归模型中，血清白蛋白水平随时间变化与Theranova透析器的使用之间没有关联（p = 0.208）。然而，血清白蛋白与炎症和营养指标有关，包括c反应蛋白、血小板与淋巴细胞的比例和蛋白质能量消耗。结论：血清白蛋白水平随时间的变化与蛋白质能量消耗、炎症、高龄、血管通路和住院有关，但与透析器类型无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.