Albumin to Total Cholesterol Ratio and Mortality in Peritoneal Dialysis

Frontiers in Medicine

article

Xianfeng Wu¹  Jiao Meng³  Lei Zhou⁴  Xiaojiang Zhan⁵  Yueqiang Wen⁶  Xiaoyang Wang⁷  Xiaoran Feng⁸  Niansong Wang¹  Fenfen Peng⁹  Junnan Wu³ 

[1] Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital;Clinical Research Center for Chronic Kidney Disease, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital;Department of Nephrology, Zhejiang University Medical College Affiliated Sir Run Run Shaw Hospital;Evergreen Tree Nephrology Association;Department of Nephrology, The First Affiliated Hospital of Nanchang University;Department of Nephrology, The Second Affiliated Hospital of Guangzhou Medical University;Department of Nephrology, The First Affiliated Hospital of Zhengzhou University;Department of Nephrology, Jiujiang No. 1 People’s Hospital;Department of Nephrology, Zhujiang Hospital of Southern Medical University

关键词: albumin to total cholesterol ratio;    mortality;    peritoneal dialysis;    cardiovascular;    prognosis;   

DOI  :  10.3389/fmed.2022.896443

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Serum albumin and total cholesterol are associated with mortality. In clinical practice, evaluating the association of combining album and total cholesterol with mortality may be more reasonable. Thus, we examined the association between serum albumin to total cholesterol ratio and mortality in peritoneal dialysis (PD) patients. Methods We conducted a retrospective cohort study of 3447 incident continuous ambulatory peritoneal dialysis (CAPD) patients from five PD centers in China from 1 January 2005 and 31 May 2020. The association between albumin to total cholesterol ratio and mortality was evaluated. Results With a median follow-up of 39.3 months, 762 (22.1%) all-cause deaths occurred, including 382 (11.1%) cardiovascular deaths. As compared with a serum albumin to total cholesterol ratio of 0.77–0.82 (reference range), a higher ratio (>0.82) was associated with increased risks of all-cause mortality[hazards ratio (HR), 1.54; 95% confidence interval (CI), 1.16–2.05, E -value = 2.45] and cardiovascular mortality (HR, 2.10; 95% CI, 1.35–3.29, E -value = 3.62). A lower ratio (<0.77) was also associated with increased risks of all-cause mortality (HR, 1.46; 95% CI, 1.10–1.94, E -value = 2.28) and cardiovascular mortality (HR, 1.78; 95% CI, 1.14–2.78, E -value = 2.96) compared with the reference. No interaction was observed in subgroup analyses of age, sex, diabetes mellitus, hypertension, prior cardiovascular disease, and hyperlipidemia, and malnutrition (serum albumin <3.6 g/dL). Conclusion An albumin to total cholesterol ratio before the start of PD between 0.77 and 0.82 was associated with a lower risk of death than a higher or lower ratio, resulting in a U-curve association. Therefore, serum albumin to total cholesterol ratio, as an inexpensive and readily available biochemical biomarker, may further improve the stratification risk of mortality in PD patients.

【 授权许可】

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