The level of serum albumin is associated with renal prognosis and renal function decline in patients with chronic kidney disease

Cheng, Tong1; Wang, Xiaoyu2; Han, Yong3; Hao, Jianbing1; Hu, Haofei4; Hao, Lirong1

2023-03-15

10.1186/s12882-023-03110-8

BMC NEPHROLOGY   Impact Factor & Quartile

1471-2369

ObjectiveThe study's purpose is to explore the link of serum albumin on renal progression in patients with chronic kidney disease (CKD).MethodsThis study was a secondary analysis of a prospective cohort study in which a total of 954 participants were non-selectively and consecutively collected from the research of CKD-ROUTE in Japan between November 2010 and December 2011. We evaluated the association between baseline ALB and renal prognosis (initiation of dialysis or 50% decline in eGFR from baseline) and renal function decline (annual eGFR decline) using the Cox proportional-hazards and linear regression models, respectively. We performed a number of sensitivity analyses to ensure the validity of the results. In addition, we performed subgroup analyses.ResultsThe included patients had a mean age of (66.86 +/- 13.41) years, and 522 (69.23%) were male. The mean baseline ALB and eGFR were (3.89 +/- 0.59) g/dL and (33.43 +/- 17.97) ml/min/1.73 m(2). The annual decline in eGFR was 2.65 mL/min/1.73 m(2)/year. 218 (28.9%) individuals experienced renal prognosis during a median follow-up period of 36.0 months. The baseline ALB was inversely linked with renal prognosis (HR = 0.61, 95%CI: 0.45, 0.81) and renal function decline (beta = -1.41, 95%CI: -2.11, -0.72) after controlling for covariates. The renal prognosis and ALB had a non-linear connection, with ALB's inflection point occurring at 4.3 g/dL. Effect sizes (HR) were 0.42 (0.32, 0.56) and 6.11 (0.98, 38.22) on the left and right sides of the inflection point, respectively. There was also a non-linear relationship between ALB and renal function decline, and the inflection point of ALB was 4.1 g/dL. The effect sizes(beta) on the left and right sides of the inflection point were -2.79(-3.62, -1.96) and 0.02 (-1.97, 1.84), respectively.ConclusionThis study shows a negative and non-linear association between ALB and renal function decline as well as renal prognosis in Japanese CKD patients. When ALB is lower than 4.1 g/dL, ALB decline was closely related to poor renal prognosis and renal function decline. From a therapeutic point of view, reducing the decline in ALB makes sense for delaying CKD progression.

Chronic kidney disease Serum albumin Renal prognosis Renal function decline Cox proportional hazards regression model Linear regression model

SCI

English

First ; Corresponding

Discipline Construction Ability Enhancement Project of the Shenzhen Municipal Health Commission[SZXJ2017031]

Urology & Nephrology

Urology & Nephrology

WOS:000952168000003

BMC

Web of Science

1.Southern Univ Sci & Technol Hosp, Dept Nephrol, 6019 Liuxian St,Xili Ave, Shenzhen 518000, Guangdong, Peoples R China
2.Hechi Peoples Hosp, Dept Nephrol, Hechi 547000, Guangxi Zhuang, Peoples R China
3.Shenzhen Second Peoples Hosp, Dept Emergency, Shenzhen 518000, Guangdong, Peoples R China
4.Shenzhen Second Peoples Hosp, Dept Nephrol, 3002 Sungang Rd, Shenzhen 518000, Guangdong, Peoples R China

Cheng, Tong,Wang, Xiaoyu,Han, Yong,et al. The level of serum albumin is associated with renal prognosis and renal function decline in patients with chronic kidney disease[J]. BMC NEPHROLOGY,2023,24(1).

Cheng, Tong,Wang, Xiaoyu,Han, Yong,Hao, Jianbing,Hu, Haofei,&Hao, Lirong.(2023).The level of serum albumin is associated with renal prognosis and renal function decline in patients with chronic kidney disease.BMC NEPHROLOGY,24(1).

Cheng, Tong,et al."The level of serum albumin is associated with renal prognosis and renal function decline in patients with chronic kidney disease".BMC NEPHROLOGY 24.1(2023).