scholarly journals SP398MALNUTRITION RISK AND LOW SERUM ALBUMIN LEVEL IN MAINTENANCE HEMODIALYSIS PATIENTS

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i480-i481
Author(s):  
Albana Gjyzari ◽  
Alma Idrizi ◽  
Margarita Gjata ◽  
Dorina Ylli ◽  
Ilirjan Gjyzari ◽  
...  
Medicine ◽  
2016 ◽  
Vol 95 (26) ◽  
pp. e4050 ◽  
Author(s):  
Wen-Hung Huang ◽  
Ching-Wei Hsu ◽  
Cheng-Hao Weng ◽  
Tzung-Hai Yen ◽  
Jui-Hsiang Lin ◽  
...  

2010 ◽  
Vol 49 (21) ◽  
pp. 2283-2288 ◽  
Author(s):  
Naoyuki Tominaga ◽  
Ryo Shimoda ◽  
Ryuichi Iwakiri ◽  
Nanae Tsuruoka ◽  
Yasuhisa Sakata ◽  
...  

2019 ◽  
Author(s):  
Xiaoyan Jia ◽  
Ping Chen ◽  
Xue Wang ◽  
Xianglei Kong ◽  
Juan Chen ◽  
...  

Abstract Background: Few studies are available on the non-linear association between serum albumin (S-Alb) level and prognosis in maintenance hemodialysis (MHD) patients. Methods: All stable MHD patients treated in our center from 2007 to 2011 were enrolled into this study. Demographics, laboratory data, hospitalization and mortality were collected; Cox regressive models were fitted to investigate predicting outcomes, restricted cubic splines (RCS) were allowing for non-linear association between S-Alb and prognosis. Results: S-Alb was independent protective factor for mortality, all-cause hospitalization, hospitalization for cardiovascular or cerebrovascular disease and hospitalization for infection. The relationships between S-Alb and mortality, all-cause hospitalization, hospitalization for cardiovascular or cerebrovascular disease were U-shaped; relationships between S-Alb and hospitalization for infection were negative linear relationships both in univariable Cox regression models and in multivariable Cox regression. Conclusions: In MHD population, there were “U-shaped” relationships between serum albumin level and mortality or hospitalization; the potential risks associated with excessive S-Alb should been taken into consideration. There was negative linear relationship between S-Alb and hospitalization for infection, S-Alb may be even more important in preventing infection in MHD population.


2019 ◽  
Vol 29 (06) ◽  
pp. 761-767 ◽  
Author(s):  
Brandon M. Henry ◽  
Santiago Borasino ◽  
Laura Ortmann ◽  
Mayte Figueroa ◽  
A.K.M. Fazlur Rahman ◽  
...  

AbstractHypoalbuminemia is associated with morbidity and mortality in critically ill children. In this multi-centre retrospective study, we aimed to determine normative values of serum albumin in neonates and infants with congenital heart disease, evaluate perioperative changes in albumin levels, and determine if low serum albumin influences post-operative outcomes. Consecutive eligible neonates and infants who underwent cardiac surgery with cardiopulmonary bypass at one of three medical centres, January 2012–August 2013, were included. Data on serum albumin levels from five data points (pre-operative, 0–24, 24–48, 48–72, 72 hours post-operative) were collected. Median pre-operative serum albumin level was 2.5 g/dl (IQR, 2.1–2.8) in neonates versus 4 g/dl (IQR, 3.5–4.4) in infants. Hypoalbuminemia was defined as <25th percentile of these values. A total of 203 patients (126 neonates, 77 infants) were included in the study. Post-operative hypoalbuminemia developed in 12% of neonates and 20% of infants; 97% occurred in the first 48 hours. In multivariable analysis, perioperative hypoalbuminemia was not independently associated with any post-operative morbidity. However, when analysed as a continuous variable, lower serum albumin levels were associated with increased post-operative morbidity. Pre-operative low serum albumin level was independently associated with increased odds of post-operative hypoalbuminemia (OR, 3.67; 95% CI, 1.01–13.29) and prolonged length of hospital stay (RR, 1.40; 95% CI, 1.08–1.82). Lower 0–24-hour post-operative serum albumin level was independently associated with an increased duration of mechanical ventilation (RR, 1.35; 95% CI, 1.12–1.64). Future studies should further assess hypoalbuminemia in this population, with emphasis on evaluating clinically meaningful cut-offs and possibly the use of serum albumin levels in perioperative risk stratification models.


1991 ◽  
Vol 9 (2) ◽  
pp. 211-219 ◽  
Author(s):  
B Coiffier ◽  
C Gisselbrecht ◽  
J M Vose ◽  
H Tilly ◽  
R Herbrecht ◽  
...  

The objectives of this study were to determine prognostic factors for response to treatment, freedom-from-relapse (FFR) survival, and overall survival of 737 aggressive malignant lymphoma patients treated with the doxorubicin, cyclophosphamide, vindesine, bleomycin, methylprednisolone, methotrexate with leucovorin, ifosfamide, etoposide, asparaginase, and cytarabine (LNH-84) regimen; to construct a prognostic index with factors isolated by multivariate analyses; and to validate this prognostic index with another set of patients. Complete response (CR) was reached in 75% of LNH-84 patients, and 30% of them relapsed. With a median follow-up of 36 months, median FFR survival and median overall survival were not reached. Low serum albumin level, high tumoral mass, weight loss, bone marrow involvement, greater than or equal to 2 extranodal sites, and increased lactic dehydrogenase (LDH) level were associated with a low response rate. Advanced stage, increased LDH level, and nonlarge-cell histologic subtypes (diffuse mixed, lymphoblastic, and small non-cleaved) were statistically associated with a high relapse rate and short FFR survival. Increased LDH level, low serum albumin level, tumoral mass larger than 10 cm, greater than or equal to 2 extranodal sites, advanced stage, and age older than 65 years were statistically associated with short overall survival. Four of these parameters, namely, LDH level, stage, number of extranodal sites, and tumoral mass, were put together to construct a prognostic index. This index partitioned LNH-84 patients into three subgroups of good, intermediate, and poor prognosis (P less than .00001): CR rates of 93%, 83%, and 61%; relapse rates of 12%, 25%, and 45%; 3-year FFR survival of 87%, 73%, and 53%, and 3-year survival of 88%, 71%, and 41%, respectively. This prognostic index was applied to a test set of patients: 155 patients treated on protocols of the Nebraska Lymphoma Study Group. Using this index, these patients had 3-year FFR survival of 70%, 40%, and 22% (P = .0002) and 3-year survival of 79%, 52%, and 31% (P = .005). In patients with aggressive lymphomas, this simple prognostic index could distinguish between patients requiring intensive treatment such as autologous bone marrow transplantation in first complete remission and those who could be treated with standard regimens.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4001-4001
Author(s):  
Maria Corrales-Yepez ◽  
Mohamed A. Kharfan-Dabaja ◽  
Jeffrey Lancet ◽  
Alan F. List ◽  
Eric Padron ◽  
...  

Abstract Abstract 4001 Background: Low serum albumin level is known to be an adverse prognostic factor in patients with malignancies such as multiple myeloma. We previously reported that severe hypoalbuminemia (<3.0 g/dl) at day +90 post allogeneic hematopoietic stem cell transplant (AHCT) was an independent predictor of non-relapse and overall mortality in patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) (Kharfan-Dabaja et al Biol Blood Marrow Transplant. 2010 Jul). In this study we examined prognostic value of serum albumin level in patients with MDS. Methods: Data were analyzed from the Moffitt Cancer Center (MCC) MDS database with chart review verification. The primary objective was to examine the role of serum albumin at time of presentation to MCC as a prognostic marker for overall survival (OS). Patients were divided into 3 groups of serum albumin levels (≤ 3.5, 3.6–4.0 and > 4.0 g/dl). The Kaplan–Meier method was used to estimate median OS. The log rank test was used to compare Kaplan–Meier survival estimates between two groups. Cox proportional hazards regression was used for multivariable analysis. Results: Between January 2001 and December 2009, 844 patients were captured by the MCC MDS database. The median age was 69 years. MDS subtypes were coded as refractory anemia (RA) (n=98;12%), refractory anemia with ring sideroblasts (RARS) (n=76;9%), del(5q) (n=20;2.4%), refractory cytopenia with multi-lineage dysplasia (RCMD) (n=96;11%), refractory anemia with excess blasts (RAEB) (n=255;30%), therapy related MDS (n=22;2.6%), and MDS-NOS (n=275; 33%). The distribution of IPSS risk groups was: 18.7% Low risk, 42.9% Intermediate-1 (Int-1), 19.9% Int-2, 5.3% High risk, and 13.2% unknown. Baseline characteristics for the three patient groups defined by serum albumin level are summarized in (Table-1). There was no difference in red blood cell transfusion dependency (RBC-TD) rate between the 3 groups (p=0.21). The median OS for all patients was 36 months (95% confidence interval (CI) 31.5–40.5 mo). Age, IPSS risk group, RBC-TD, Serum ferritin were statistically significant prognostic factors in univariable analysis. The median OS was 19 mo (95%CI= 14.9–23.1 mo), 35 mo (95%CI= 28.7–41.3 mo), and 53 mo (95%CI= 44.7–61.3 mo) for patients with serum albumin levels ≤ 3.5 g/dl, 3.6–4.0 g/dl, > 4.0 g/dl, respectively. (Figure-1) (p= <0.005). After adjustment for age, RBC-TD, OS was statistically significantly inferior among MDS patients with lower serum albumin (Hazard Ratio (HR) = 0.79.; 95%CI= 0.69–0.90; p= 0.001), and higher-risk IPSS group (HR=1.67; 95%CI=1.48-1.87; p= <0.005). The overall rate of AML transformation was 29.2%. Rate of AML transformation was higher in patients with lower serum albumin, 38% in patients with serum albumin ≤ 3.5 g/dl, 30% for patients 3.6–4.0 g/dl, and 23% in patients with serum albumin > 4.0 g/dl (p-value 0.005). Among patients in the Low/Int-1 IPSS risk group, the median OS was 28 mo (95%CI=15.7-40.3 mo), 48 mo (95%CI=38.8-58.0 mo), and 60 mo (95%CI=47.6-72.4 mo) for patients with serum albumin levels ≤ 3.5 g/dl, 3.6–4.0 g/dl and > 4.0 g/dl, respectively (p=0.003). Among patients in the Int-2/High IPSS risk group, the median OS was 16 mo (95%CI 13.3–15.7 mo), 22 mo (95%CI 18.0–26.0 mo), and 21 mo (95%CI 8.8–33.2 mo) respectively for patients with serum albumin levels ≤ 3.5 g/dl, 3.6–4.0 g/dl and > 4.0 g/dl, respectively p=0.03). Conclusion: In this retrospective analysis of a large single institution MDS database, serum albumin is found to be an independent prognostic factor for OS and AML transformation in MDS patients. The prognostic power of low serum albumin was greatest among patients with Low/Int-1 IPSS risk group, but remained an independent variable across all risk groups. Serum albumin may also be a surrogate marker of general health, co- morbidities, and performance status. Disclosures: No relevant conflicts of interest to declare.


2017 ◽  
Vol 2017 ◽  
pp. 1-9
Author(s):  
Yit-Sheung Yap ◽  
Kai-Ting Ting ◽  
Wen-Che Chi ◽  
Cheng-Hao Lin ◽  
Yi-Chun Liu ◽  
...  

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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