Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar 31;39(1):47-53.
doi: 10.23876/j.krcp.19.088.

Association of hypoalbuminemia with short-term and long-term mortality in patients undergoing continuous renal replacement therapy

Jong Joo Moon  1 , Yaerim Kim  1 , Dong Ki Kim  1 , Kwon Wook Joo  1 , Yon Su Kim  1 , Seung Seok Han  1
Affiliations

Association of hypoalbuminemia with short-term and long-term mortality in patients undergoing continuous renal replacement therapy

Jong Joo Moon et al. Kidney Res Clin Pract. .

Abstract

Background: Hypoalbuminemia reflects several pathological conditions, including nutritional deficiencies and chronic inflammation. However, its relationship with short-term and long-term mortality in patients undergoing continuous renal replacement therapy (CRRT) remains unclear. The present study aimed to assess the effect of hypoalbuminemia on mortality in a large cohort of patients undergoing CRRT.

Methods: The study retrospectively reviewed 1,581 patients who underwent CRRT for the treatment of acute kidney injury from 2010 to 2016. The patients were categorized by tertiles of serum albumin levels at CRRT initiation. The odds ratios and hazard ratios for the risk of all-cause mortality were calculated before and after adjustment for multiple covariates.

Results: The mean albumin level was 2.7 ± 0.6 g/dL at CRRT initiation. During a median follow-up period of 14 days (maximum, 4 years), 1,040 patients (65.8%) died. The risk of overall mortality was higher in the first tertile group than in the third tertile group (hazard ratio, 1.9 [1.63-2.21]). When the mortality rate was stratified by timeframe, the risk was steadily higher in the first tertile group than in the third tertile group (odds ratios: 3.0 [2.34-3.87] for 2-week mortality, 2.7 [2.12-3.52] for 1-month mortality, 2.7 [2.08-3.53] for 6-month mortality, and 2.8 [2.11-3.62] for 1-year mortality). Additionally, the rates of intensive care unit mortality and in-hospital mortality were higher in the first tertile group than in the third tertile group.

Conclusion: The initial hypoalbuminemia was independently associated with short-term and long-term mortality in patients undergoing CRRT. Thus, the serum albumin level should be monitored during CRRT.

Keywords: Acute kidney injury; Continuous renal replacement therapy; Hypoalbuminemia; Mortality.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest

All authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. Nonlinear relationship between the serum albumin level and predicted probability of all-cause mortality.
Figure 2
Figure 2. Kaplan-Meier survival curves according to the tertiles of serum albumin.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Lameire NH, Bagga A, Cruz D, et al. Acute kidney injury: an increasing global concern. Lancet. 2013;382:170–179. doi: 10.1016/S0140-6736(13)60647-9. - DOI - PubMed
    1. Mehta RL, Cerdá J, Burdmann EA, et al. International Society of Nephrology’s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet. 2015;385:2616–2643. doi: 10.1016/S0140-6736(15)60126-X. - DOI - PubMed
    1. Cerdá J, Lameire N, Eggers P, et al. Epidemiology of acute kidney injury. Clin J Am Soc Nephrol. 2008;3:881–886. doi: 10.2215/CJN.04961107. - DOI - PubMed
    1. Hoste EA, Bagshaw SM, Bellomo R, et al. Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med. 2015;41:1411–1423. doi: 10.1007/s00134-015-3934-7. - DOI - PubMed
    1. Srisawat N, Sileanu FE, Murugan R, et al. Acute Kidney Injury-6 Study Group. Variation in risk and mortality of acute kidney injury in critically ill patients: a multicenter study. Am J Nephrol. 2015;41:81–88. doi: 10.1159/000371748. - DOI - PubMed

LinkOut - more resources