Early changes in serum albumin: impact on 2-year mortality in incident hemodialysis patients

Jornal Brasileiro de Nefrologia

Giselly Rosa Modesto Pereira¹  Jorge Paulo Strogoff-de-matos¹  Frederico Ruzany¹  Sergio Fernando Ferreira Dos Santos¹  Eufrônio D'almeida Filho¹  Marcos Sandro Fernandes De Vasconcelos¹  Ana Beatriz Barra¹  Jocemir Ronaldo Lugon¹ 

关键词: kidney failure;    chronic;    mortality;    renal dialysis;    serum albumin;    albumina sérica;    diálise renal;    falência renal crônica;    mortalidade;   

DOI  :  10.5935/0101-2800.20150032

来源: SciELO

【 摘 要 】

AbstractIntroduction/objective:We evaluated the predictability of early changes in serum albumin (sAlb) on the two-year mortality of incident hemodialysis patients.Methods:Observational, longitudinal retrospective study using the database of Fresenius Medical Care of Latin America. Adult patients starting dialysis from January/2000 to June/2004, from 25 centers were included. Changes in sAlb during the first 3 months on hemodialysis were used as the main predictor. The outcome was death from any cause.Results:1,679 incident patients were included. They were 52 ± 15 years old, 58.7% male and 21.5% diabetic, with a median sAlb of 38 g/L (bromocresol green). 923 patients had sAlb < 38 g/L (Low sAlb Group) and 756 ones had sAlb > 38.0 g/L (Adequate sAlb Group). The mortality was significantly higher in Low sAlb Group (17% vs. 11%, p < 0.001). Early changes in sAlb significantly affected two-year mortality. Factoring the Kaplan Meier curve of Low sAlb Group by the presence of an increase in sAlb uncovered of a statistically significant difference in mortality favoring the ones whose sAlb went up (19% vs. 15%, p = 0.043). Differently, patients from Adequate sAlb Group with a decrease in their sAlb had a statistically higher mortality rate (13% vs. 8%, p = 0.029).Conclusions:Early sAlb changes showed a significant predictive power on mortality at 2 years in incident hemodialysis patients. Those with low initial sAlb may have a better prognosis if their sAlb rises. In contrast, patients with satisfactory initial levels can have a worsening of their prognosis in the case of an early reduction in sAlb.

【 授权许可】

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