The Impact of Maintaining Normal Serum Albumin Level Following Living Related Liver Transplantation: Does Serum Albumin Level Affect the Course? A Pilot Study

Objectives. The aim of the study was to identify the factors associated with repeated arteriovenous fistula (AVF) failure within 1-year, especially the impact of aortic arch calcification (AAC) on patency of AVF.Materials and Methods. We retrospectively assessed chest radiography in hemodialysis patients who had undergone initial AVF. The extent of AAC was categorized into four grades (0–3). The association between AAC grade, other clinical variables, and repeated failure of AVF was then analyzed by binary logistic regression analysis.Results. This study included 284 patients (158 males, mean age61.7±13.1years). Patients with higher AAC grade were older, had more frequently diabetes mellitus and cardiovascular disease, had lower diastolic blood pressure, and had higher corrected calcium and lower intact parathyroid hormone levels. In multivariate analysis, the presence of higher AAC grade (odds ratio (95% confidence interval): 2.98 (1.43–6.23);p=0.004), lower mean corrected calcium (p=0.017), and mean serum albumin level (p=0.008) were associated with repeated failure of AVF.Conclusions. The presence of higher AAC grade, lower mean corrected calcium and mean serum albumin level were independently associated with repeated AVF failure within 1 year in hemodialysis patients.

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Serum albumin level for prediction of all-cause mortality in acute coronary syndrome patients: a meta-analysis

Bioscience Reports ◽

10.1042/bsr20190881 ◽

2020 ◽

Vol 40 (1) ◽

Cited By ~ 3

Author(s):

Lingjun Zhu ◽

Miaomiao Chen ◽

Xiaoping Lin

Keyword(s):

Acute Coronary Syndrome ◽

Serum Albumin ◽

Mortality Risk ◽

Serum Albumin Level ◽

Meta Analysis ◽

Albumin Level ◽

Coronary Syndrome ◽

All Cause Mortality ◽

The Impact ◽

Low Serum

Abstract The prognostic utility of serum albumin level as a predictor of survival in patients with acute coronary syndrome (ACS) has attracted considerable attention. This meta-analysis sought to investigate the prognostic value of serum albumin level for predicting all-cause mortality in ACS patients. A systematic literature search was conducted in Pubmed and Embase databases until 5 March 2019. Epidemiological studies investigating the association between serum albumin level and all-cause mortality risk in ACS patients were included. Eight studies comprising 21667 ACS patients were included. Meta-analysis indicated that ACS patients with low serum albumin level had an increased risk of all-cause mortality (risk ratio [RR] 2.15; 95% confidence interval [CI] 1.68–2.75) after adjusting for important covariates. Subgroup analysis showed that the impact of low serum albumin level was stronger in hospital mortality (RR 3.09; 95% CI 1.70–5.61) than long-term all-cause mortality (RR 1.75; 95% CI 1.54–1.98). This meta-analysis demonstrates that low serum albumin level is a powerful predictor of all-cause mortality in ACS patients, even after adjusting usual confounding factors. However, there is lack of clinical trials to demonstrate that correcting serum albumin level by means of intravenous infusion reduces the excess risk of death in ACS patients.

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Impact of Nutritional Status on Peritonitis in CAPD Patients

Peritoneal Dialysis International ◽

10.1177/089686080702700110 ◽

2007 ◽

Vol 27 (1) ◽

pp. 42-47 ◽

Cited By ~ 40

Author(s):

Narayan Prasad ◽

Amit Gupta ◽

Raj K. Sharma ◽

Archna Sinha ◽

Ramesh Kumar

Keyword(s):

Nutritional Status ◽

Serum Albumin ◽

Serum Albumin Level ◽

Risk Index ◽

Univariate Analysis ◽

Albumin Level ◽

Calorie Intake ◽

Cox Regression Analysis ◽

Nutritional Risk Index ◽

The Impact

Objective To determine the impact of nutritional status on peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) in a developing country. Methods 56 patients with end-stage renal disease on CAPD were randomly selected for this study. These patients were assessed for nutritional status and peritonitis episodes. Nutritional parameters were assessed by anthropometry, diet, body mass index (BMI), Nutritional Risk Index (NRI), serum albumin level, and Subjective Global Assessment (SGA). Based on SGA, patients were categorized into either group 1 (malnutrition, n = 31) or group 2 (normal nutritional status, n = 25). Peritonitis was considered the primary outcome and was compared between the two groups. Results Demographic profiles, Kt/V, creatinine clearance, and mean follow-up of the two groups were similar. Number of peritonitis episodes was significantly higher in patients with malnutrition (25/31) compared to patients with normal nutritional status (4/25) ( p = 0.001). Mean peritonitis rate per patient per year was also significantly higher in patients with malnutrition (0.99 ± 1.07) compared to patients with normal nutritional status (0.18 ± 0.42) ( p = 0.007). On univariate analysis, malnutrition based on SGA ( p = 0.009), NRI ( p = 0.02), serum albumin level ( p = 0.005), and calorie intake ( p = 0.006) was a significant predictor of peritonitis. On multivariate Cox regression analysis, only SGA ( p = 0.001, odds ratio 0.08, 95% confidence interval 0.02 – 0.36) was found to be a significant predictor of peritonitis. On general linear model, the observed power of prediction of peritonitis was 0.96 based on SGA. On Kaplan–Meier survival analysis, peritonitis-free survival in patients with normal nutrition (42 months) was significantly higher compared to patients with malnutrition (21 months) based on SGA (log rank p = 0.003). Conclusion We conclude that peritonitis rate is high in patients with malnutrition and that malnutrition indices, especially SGA, can predict the peritonitis rate in CAPD patients.

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Albumin Is a Prognostic Factor for Overall Survival in Newly Diagnosed Patients with Acute Myeloid Leukemia (AML)

Blood ◽

10.1182/blood.v118.21.4253.4253 ◽

2011 ◽

Vol 118 (21) ◽

pp. 4253-4253

Author(s):

Awais M. Khan ◽

Jeffrey E. Lancet ◽

Mohamed A. Kharfan-Dabaja ◽

Najla H Al Ali ◽

Alan F. List ◽

...

Keyword(s):

Overall Survival ◽

Serum Albumin ◽

Induction Chemotherapy ◽

Serum Albumin Level ◽

Cox Regression ◽

Albumin Level ◽

Normal Serum ◽

Newly Diagnosed ◽

Kaplan Meier ◽

History Of

Abstract Abstract 4253 Background: Hypoalbuminemia (HA) is a strong predictor of poor clinical outcomes in many medical conditions. Low serum albumin is recognized as an adverse prognostic factor in patients with neoplastic diseases such as multiple myeloma, melanoma, and colon cancer. Severe hypoalbuminemia (<3.0 g/dl) at day +90 post allogeneic hematopoietic cell transplant (AHCT) was reported as an independent predictive variable for non-relapse mortality and overall survival (Kharfan-Dabaja, et al Biol Blood Marrow Transplant 2009; 15). A separate study conducted by our group showed that in patients with relapsed and refractory AML, serum albumin < 3.5 g/dl prior to salvage chemotherapy, correlated with lower complete remission (CR) rate and inferior overall survival (OS) (Komrokji, et al ASH 2009). We examined the prognostic value of serum albumin level prior to induction chemotherapy in patients with newly diagnosed AML. Methods: Data were collected retrospectively in a cohort of newly diagnosed AML patients who received induction chemotherapy (3+ 7 regimen). The primary objective of this study is to examine the relationship between serum albumin at baseline and probability for achieving complete remission (CR) or incomplete remission (CRi) and overall survival (OS). All analyses were conducted using SPSS version 19.0. The Kaplan–Meier method was used to estimate median overall survival; chi-square test was used for comparison of categorical variables and t-test for continuous variables. Log rank test was used to compare Kaplan–Meier survival estimates between two groups and Cox regression for multivariable analysis. Results: Between November 2004 and July 2007, 135 patients who received 3+7 induction chemotherapy at Moffitt Cancer Center were included in this analysis. Patient baseline characteristics were similar between patients with baseline serum albumin < 3.5 g/dl (HA) and those with serum albumin ≥ 3.5 g/dl (no HA) with respect to age, sex, FAB subtype, history of antecedent MDS, karyotype, and chemotherapy. Patients with HA, mean age was 60 years compared to 56.5 years in non HA group. The median OS for patients with HA was 221 days (95%CI 149.5–292.5) compared to 421 days (95%CI 236.7–605) with normal serum albumin (p<0.005). (Figure-1) The CR/CRi rate was 64%% for HA and 77.6% for those with normal albumin (p=0.09). In a multivariable Cox regression analysis including age ≥ 60 years, history of MDS, karyotype, and serum albumin level at baseline; only age, karyotype and serum albumin were independent predictors of OS [Hazard ratio 0.47 (95%CI 0.31–0.71) (p<0.005) for normal serum albumin group]. Conclusion: In this cohort of patients with newly diagnosed AML, we demonstrate that hypoalbuminemia < 3.5 g/dl is an independent covariate for overall survival with conventional chemotherapy management. Serum albumin is a surrogate marker of general health, comorbidities, and performance status. The prognostic value of low serum albumin should be validated in a prospective study. Disclosures: No relevant conflicts of interest to declare.

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The Impact of Pretransplant Serum Albumin Level on the Long- Term Posttransplant Graft Outcome

Transplantation Journal ◽

10.1097/00007890-201211271-01658 ◽

2012 ◽

Vol 94 (10S) ◽

pp. 844

Author(s):

O. J. Kwon ◽

J. Y. Choi ◽

C. M. Kang

Keyword(s):

Serum Albumin ◽

Serum Albumin Level ◽

Albumin Level ◽

Graft Outcome ◽

The Impact

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Albumin as a prognostic factor for overall survival in newly diagnosed patients with acute myeloid leukemia (AML).

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.6586 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 6586-6586

Author(s):

Awais M. Khan ◽

Jeffrey E. Lancet ◽

Mohamed A. Kharfan-Dabaja ◽

Najla Al Ali ◽

Alan F. List ◽

...

Keyword(s):

Overall Survival ◽

Serum Albumin ◽

Induction Chemotherapy ◽

Prognostic Value ◽

Serum Albumin Level ◽

Albumin Level ◽

Normal Serum ◽

Newly Diagnosed ◽

Kaplan Meier ◽

History Of

6586 Background: Hypoalbuminemia (HA) is an adverse prognostic factor in multiple neoplastic diseases. Severe hypoalbuminemia (<3.0 g/dl) at day +90 post allogeneic hematopoietic cell transplant (AHCT) was reported as an independent predictive variable for non-relapse mortality and overall survival (Kharfan-Dabaja, et al Biol Blood Marrow Transplant 2009; 15). We examined the prognostic value of serum albumin level prior to induction chemotherapy in patients with newly diagnosed AML. Methods: Data were collected retrospectively in newly diagnosed AML patients receiving induction chemotherapy (3+ 7 regimen). Primary objective was to examine the relationship between serum albumin at baseline and probability of achieving complete remission (CR) or incomplete remission (CRi) and overall survival (OS). The Kaplan–Meier method used to estimate median overall survival; chi-square test used for comparison of categorical variables and t-test for continuous variables. Log rank test used to compare Kaplan–Meier survival estimates between two groups. Results: Between November 2004 to July 2007, 135 patients who received 3+7 induction chemotherapy were included. Patient baseline characteristics were similar between patients with serum albumin < 3.5 g/dl (HA) and those with serum albumin ≥ 3.5 g/dl (no HA) with respect to age, sex, FAB subtype, history of antecedent MDS, karyotype, and chemotherapy . In patients with HA, mean age was 60 years compared to 56.5 years in non HA group. The median OS for patients with HA was 221 days (95%CI 149.5-292.5) compared to 421 days (95%CI 236.7-605) with normal serum albumin (p<0.005). (Figure-1) The CR/CRi rate was 64%% for HA and 77.6% for those with normal albumin (p=0.09). In a multivariable Cox regression analysis including age ≥ 60 years, history of MDS, karyotype, and serum albumin level at baseline; only age, karyotype and serum albumin were independent predictors of OS [Hazard ratio 0.47 (95%CI 0.31-0.71) (p<0.005) for normal serum albumin group]. Conclusions: In newly diagnosed AML, we demonstrate that hypoalbuminemia < 3.5 g/dl is an independent covariate for overall survival with conventional chemotherapy management. The prognostic value of low serum albumin should be validated in a prospective study.

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Serum Albumin Levels in Severe Traumatic Brain Injury: Role as a Predictor of Outcome

Indian Journal of Neurotrauma ◽

10.1055/s-0039-1698714 ◽

2020 ◽

Vol 17 (01) ◽

pp. 24-27

Author(s):

Raghavendra Nayak ◽

Nitin Jagdhane ◽

Sanjeev Attry ◽

Samarendranath Ghosh

Keyword(s):

Traumatic Brain Injury ◽

Serum Albumin ◽

Severe Head Injury ◽

Serum Albumin Level ◽

Albumin Level ◽

Normal Serum ◽

Severe Tbi ◽

The Mean ◽

Low Serum

Abstract Background Serum albumin has long been considered as an outcome marker in various critical illnesses. The aim of our study is to ascertain the role of serum albumin as a predictor of outcome in severe head injury patients. Materials and Methods This is a prospective observational study of patients with severe traumatic brain injury (TBI). Depending on the serum albumin level at admission, patients were dichotomized into two groups: one with normal serum albumin and other with hypoalbuminemia. Their outcomes at 6-month follow-up were assessed by the modified Glasgow Outcome Score. Result Eighty patients (57 males and 23 females) with severe TBI were included in the study. The mean age of the study patients was 39.6 + 13.1 years and the mean serum albumin level at admission was 3.7 + 1.2 g/dL with lowest being 2.2 mmol/L and highest being 6.1 mmol/L. Thirty-four patients (42.5%) had low serum albumin level (< 3.5 g/dL) at admission. At 6-month follow-up, 58 (72.5%) patients had a good neurological outcome and 22 (27.5%) had a poor outcome. The group with normal serum albumin levels showed a significantly better outcome compared with the hypoalbuminemia group (p = 0.01). On multiple regression analysis, low serum albumin emerged as the only predictor of the poor outcome in severe head injury patients. Conclusion Serum albumin at admission is an independent predictor of outcome in severe TBI patients. Larger prospective studies are required to confirm these findings.

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