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Serum albumin changes and mortality risk of peritoneal dialysis patients

  • Nephrology - Original Paper
  • Published:
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Abstract

Purpose

Initial or single time point serum albumin levels have been shown to be important in predicting the prognosis of peritoneal dialysis (PD) patients. However, we assume the dynamic change and trend of albumin after PD are essential. We aimed to investigate the association between baseline albumin levels, albumin trajectories, and patient mortality in a retrospective cohort study.

Methods

In this retrospective cohort study, 547 incident PD patients were enrolled from Peking University Third Hospital. Date were collected by medical records review, including age, gender, body mass index, primary disease, comorbidities, and laboratory tests. A joint model for longitudinal data and time-to-event data was used to establish the relationship between serum albumin trajectories and mortality risk of PD patients.

Results

The albumin trajectories was negatively correlated with risk of death. The increase in the current value of albumin trajectories at time points t after PD was associated with decreased risk of death (HR = 0.881, p < 0.0001). There was no statistical association between initial albumin and risk of death (HR = 1.030, 95% CI 0. 995–1.066). The results showed that increased age, higher albumin-corrected Ca levels, and higher eGFR values were risk factors for death. In addition, predictors of low albumin levels are increased PD time, increased age, increased albumin-corrected Ca, and decreased BMI as well as initial albumin levels.

Conclusion

This study demonstrates that albumin trajectories after PD is better than initial serum albumin level in predicting mortality risk. Increasing albumin level over time can improve the prognosis of PD patients.

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Acknowledgements

The authors would like to thank all the staff of PD center in Peking University Third Hospital. This work was supported by Chinese Society of Nephrology (No. 1405046058) and Fund of Peking University Health Science Center (BMU20160584) and grants from National Natural Science Foundation of China (Project 30900681).

Funding

This work was supported by Chinese Society of Nephrology (No. 1405046058) and Fund of Peking University Health Science Center (BMU20160584) and grants from National Natural Science Foundation of China (Project 30900681). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing, 100191, People’s Republic of China

    Xiaoxiao Wang

  2. Department of Nephrology, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing, 100191, People’s Republic of China

    Qingfeng Han, Tao Wang & Wen Tang

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  1. Xiaoxiao Wang
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  2. Qingfeng Han
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  3. Tao Wang
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  4. Wen Tang
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Correspondence to Wen Tang.

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Wang, X., Han, Q., Wang, T. et al. Serum albumin changes and mortality risk of peritoneal dialysis patients. Int Urol Nephrol 52, 565–571 (2020). https://doi.org/10.1007/s11255-020-02389-y

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