{"title":"Relationship of serum albumin at initiation of incident peritoneal dialysis with cardiovascular and overall survival.","authors":"Jane Pitanupong, Arunchai Chang","doi":"10.5414/CN110979","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To investigate whether serum albumin level at peritoneal dialysis (PD) initiation is associated with mortality in end-stage kidney disease (ESKD) patients.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed the records of ESKD patients on continuous ambulatory PD during 2015 - 2021. Patients with initial albumin ≥ 3 mg/dL were placed in the high albumin group and those with albumin < 3 mg/dL in the low albumin group. A Cox proportional hazards model was used to identify variables influencing survival.</p><p><strong>Results: </strong>Among 77 patients, 46 were in the high albumin group and 31 in the low albumin group. The high albumin group had significantly increased cardiovascular (1-, 3-, and 5-year cumulative survival rates of 93 vs. 83%, 81 vs. 64%, and 81 vs. 47%, respectively; log-rank p = 0.016) and overall survival (1-, 3-, and 5-year cumulative survival rates of 84 vs. 77%, 67 vs. 50%, and 60 vs. 29%, respectively; log-rank p = 0.017). Serum albumin < 3 g/dL was an independent predictor of cardiovascular (hazard ratio (HR) 4.401; 95% confidence interval (CI), 1.584 - 12.228; p = 0.004) and overall survival (HR 2.927; 95% CI 1.443 - 5.934, p = 0.003).</p><p><strong>Conclusion: </strong>Low albumin levels at PD initiation are an independent risk factor for decreased cardiovascular and overall survival. Further research is required to know whether increasing albumin levels before PD would decrease mortality.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":"99 6","pages":"265-273"},"PeriodicalIF":1.1000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5414/CN110979","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Aims: To investigate whether serum albumin level at peritoneal dialysis (PD) initiation is associated with mortality in end-stage kidney disease (ESKD) patients.
Materials and methods: We retrospectively reviewed the records of ESKD patients on continuous ambulatory PD during 2015 - 2021. Patients with initial albumin ≥ 3 mg/dL were placed in the high albumin group and those with albumin < 3 mg/dL in the low albumin group. A Cox proportional hazards model was used to identify variables influencing survival.
Results: Among 77 patients, 46 were in the high albumin group and 31 in the low albumin group. The high albumin group had significantly increased cardiovascular (1-, 3-, and 5-year cumulative survival rates of 93 vs. 83%, 81 vs. 64%, and 81 vs. 47%, respectively; log-rank p = 0.016) and overall survival (1-, 3-, and 5-year cumulative survival rates of 84 vs. 77%, 67 vs. 50%, and 60 vs. 29%, respectively; log-rank p = 0.017). Serum albumin < 3 g/dL was an independent predictor of cardiovascular (hazard ratio (HR) 4.401; 95% confidence interval (CI), 1.584 - 12.228; p = 0.004) and overall survival (HR 2.927; 95% CI 1.443 - 5.934, p = 0.003).
Conclusion: Low albumin levels at PD initiation are an independent risk factor for decreased cardiovascular and overall survival. Further research is required to know whether increasing albumin levels before PD would decrease mortality.
目的:探讨腹膜透析(PD)开始时血清白蛋白水平是否与终末期肾病(ESKD)患者的死亡率相关。材料和方法:我们回顾性回顾了2015 - 2021年间ESKD患者连续门诊PD的记录。将初始白蛋白≥3mg /dL的患者分为高白蛋白组和白蛋白组。结果:77例患者中,高白蛋白组46例,低白蛋白组31例。高白蛋白组的心血管(1、3、5年)累积生存率分别为93比83%、81比64%、81比47%;Log-rank p = 0.016)和总生存率(1、3和5年累积生存率分别为84比77%,67比50%,60比29%;Log-rank p = 0.017)。结论:帕金森病发病时低白蛋白水平是心血管和总生存率降低的独立危险因素。在帕金森病前增加白蛋白水平是否会降低死亡率还需要进一步的研究。
期刊介绍:
Clinical Nephrology appears monthly and publishes manuscripts containing original material with emphasis on the following topics: prophylaxis, pathophysiology, immunology, diagnosis, therapy, experimental approaches and dialysis and transplantation.