scholarly journals Impact of serum albumin level and variability on short-term cardiovascular-related and all-cause mortality in patients on maintenance hemodialysis

Medicine ◽  
2021 ◽  
Vol 100 (43) ◽  
pp. e27666
Author(s):  
Chun Chen ◽  
Jing Zhang ◽  
Zemei Zhou ◽  
Jiguo Liu ◽  
Chunyin Li ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Maintenance Hemodialysis ◽  
Short Term ◽  
All Cause Mortality

scholarly journals In maintenance hemodialysis patients, there were “U-shaped” relationships between serum albumin level and mortality or hospitalization, negative linear relationship between serum albumin level and hospitalization for infection.

2019 ◽  
Author(s):  
Xiaoyan Jia ◽  
Ping Chen ◽  
Xue Wang ◽  
Xianglei Kong ◽  
Juan Chen ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Cerebrovascular Disease ◽  
Linear Relationship ◽  
Serum Albumin Level ◽  
Cox Regression ◽  
Albumin Level ◽  
Maintenance Hemodialysis ◽  
Linear Association ◽  
Non Linear ◽  
Negative Linear Relationship

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.

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

2020 ◽  
Vol 40 (1) ◽  
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.

scholarly journals Analysis of risk factors and outcome in peritoneal dialysis patients with early-onset peritonitis: a multicentre, retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e029949 ◽  
Author(s):  
Xiaoyan Ma ◽  
Yingfeng Shi ◽  
Min Tao ◽  
Xiaolu Jiang ◽  
Yi Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Albumin ◽  
Retrospective Cohort ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
First Episode ◽  
Lower Serum ◽  
Factors Associated ◽  
All Cause Mortality ◽  
Technique Failure

ObjectivesTo investigate the risk factors associated with early-onset peritonitis (EOP) and their influence on patients’ technique survival and mortality.Study designRetrospective, cohort study.SettingThree peritoneal dialysis (PD) units in Shanghai.ParticipantsPD patients from 1 June 2006 to 1 May 2018 were recruited and followed up until 31 December 2018. According to time-to-first episode of peritonitis, patients were divided into non-peritonitis (n=144), EOP (≤6 months, n=74) and late-onset peritonitis (LOP) (>6 months, n=139).Primary and secondary outcome measuresEOP was defined as the first episode of peritonitis occurring within 6 months after the initiation of PD. The outcomes were all-cause mortality and technique failure.ResultsOf the 357 patients, 74 (20.7%) patients developed their first episode of peritonitis within the first 6 months. Compared with the LOP group, the EOP group had older ages, more female patients, higher Charlson Comorbidity Index (CCI) score, lower serum albumin levels and renal function at the time of initiation of PD, and higher diabetes mellitus and peritonitis rates (p<0.05).Staphylococcuswas the most common Gram-positive organism in both EOP and LOP groups. The multivariate logistic regression analysis showed that factors associated with EOP included a higher CCI score (OR 1.285, p=0.011), lower serum albumin level (OR 0.924, p=0.016) and lower Kt/V (OR 0.600, p=0.018) at start of PD. In the Cox proportional-hazards model, EOP was more likely a predictor of technique failure (HR 1.801, p=0.051). There was no difference between EOP and LOP for all-cause mortality.ConclusionA higher CCI score and lower serum albumin level and Kt/V at PD initiation were significantly associated with EOP. EOP also predicted a high peritonitis rate and poor clinical outcome.

Correlation of Serum Albumin Level with Short Term Outcome of Acute Ischemic Stroke Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed Saad El-Din Mahmud ◽  
Hala Mahmoud EL-Khawas ◽  
Hossam El Din Mahmoud Afify ◽  
Mohamed Mohamed Tawfik
Keyword(s):  
Ischemic Stroke ◽  
Serum Albumin ◽  
Acute Ischemic Stroke ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Short Term ◽  
The Mean ◽  
Discharge From Hospital

Abstract Objectives We aimed to Detect if there is association between serum albumin level in acute ischemic stroke patients and its short term neurological and functional outcome in a tertiary care hospital in Cairo. Methods The study was carried out as descriptive (cross-sectional) study conducted on 50 cases first-ever acute ischemic stroke patients were enrolled between June 2018 to December 2018 with follow up after 30 days of discharge from hospital. Inclusion and exclusion criteria were strictly exercised. National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) score was noted. Serum albumin (SA) was estimated from blood Clinical, functional, and radiological evaluation was done for the patients. Statistical SPSS 20.0 software and Microsoft excel were used for statistical analysis (P ≤ 0.05).Relationship between serum albumin and stroke outcome was determined. Results A total of 50 stroke cases were thus included in the study comprising 34 males and 16 females. The mean age of patients was 40-65 [59.26±6.25] years, we found the most prevalent risk factors in the present study results were hypertension 36 (72.0%). The mean serum level of albumin were (3.73±0.63) on day o of onset and (3.72±0.63) after 30 days of discharge from hospital. Bivariate analysis shows serum albumin was inversely associated with NIHS score and mRS on day o of onset and after 30 days of discharge from hospital which were NIHSS(r= -0.264, P = 0.044) (r= -0.645, P = &lt;0.001) and mrs (r= -0.321, P = 0.031) (r= -0.587, P = &lt;0.001) respectively. Conclusion Hypoalbuminemia had influence to degree of stroke severity, degree of disability and functional outcome. Serum albumin levels had a negatively correlation with NIHSS score and modified Rankin scale. Low serum albumin levels associated with poor prognosis in acute ischemic stroke patients.

scholarly journals Gait speed and handgrip strength as predictors of all-cause mortality and cardiovascular events in hemodialysis patient

2020 ◽  
Author(s):  
Yu Ho Lee ◽  
Jin Sug Kim ◽  
Su Woong Jung ◽  
Hyeon Seok Hwang ◽  
Ju-Young Moon ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Clinical Outcomes ◽  
Physical Performance ◽  
Gait Speed ◽  
Cardiovascular Events ◽  
Handgrip Strength ◽  
Hemodialysis Patients ◽  
Albumin Level ◽  
Maintenance Hemodialysis ◽  
All Cause Mortality

Abstract Background Low physical performance in patients undergoing maintenance hemodialysis is associated with a high mortality rate. We investigated the clinical relevance of gait speed and handgrip strength, the two most commonly used methods of assessing physical performance. Methods We obtained data regarding gait speed and handgrip strength from 277 hemodialysis patients and evaluated their relationships with baseline parameters, mental health, plasma inflammatory markers, and major adverse clinical outcomes. Low physical performance was defined by the recommendations suggested by the Asian Working Group on Sarcopenia. Results The prevalence of low gait speed and handgrip strength was 28.2% and 44.8%, respectively. Old age, low serum albumin levels, high comorbidity index score, and impaired cognitive functions were associated with low physical performance. Patients with isolated low gait speed exhibited a general trend for worse quality of life than those with isolated low handgrip strength. Gait speed and handgrip strength showed very weak correlations with different determining factors (older age, the presence of diabetes, and lower serum albumin level for low gait speed, and lower body mass index and the presence of previous cardiovascular events for low handgrip strength). Patients with low gait speed and handgrip strength had elevated levels of plasma endocan and matrix metalloproteinase-7 and the highest risks for all-cause mortality and cardiovascular events among the groups (adjusted hazard ratio of 2.72, p = 0.024). Elderly patients with low gait speed and handgrip strength were at the highest risk for poor clinical outcomes. Conclusion Gait speed and handgrip strength reflected distinctive aspects of patient characteristics and the use of both factors improved the prediction of adverse clinical outcomes in hemodialysis patients. Gait speed seems to be a better indicator of poor patient outcomes than is handgrip strength.

scholarly journals Gait speed and handgrip strength as predictors of all-cause mortality and cardiovascular events in hemodialysis patient

2020 ◽  
Author(s):  
Yu Ho Lee ◽  
Jin Sug Kim ◽  
Su Woong Jung ◽  
Hyeon Seok Hwang ◽  
Ju-Young Moon ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Clinical Outcomes ◽  
Physical Performance ◽  
Gait Speed ◽  
Cardiovascular Events ◽  
Handgrip Strength ◽  
Hemodialysis Patients ◽  
Albumin Level ◽  
Maintenance Hemodialysis ◽  
All Cause Mortality

Abstract Background Low physical performance in patients undergoing maintenance hemodialysis is associated with a high mortality rate. We investigated the clinical relevance of gait speed and handgrip strength, the two most commonly used methods of assessing physical performance.Methods We obtained data regarding gait speed and handgrip strength from 277 hemodialysis patients and evaluated their relationships with baseline parameters, mental health, plasma inflammatory markers, and major adverse clinical outcomes. Low physical performance was defined by the recommendations suggested by the Asian Working Group on Sarcopenia.Results The prevalence of low gait speed and handgrip strength was 28.2% and 44.8%, respectively. Old age, low serum albumin levels, high comorbidity index score, and impaired cognitive functions were associated with low physical performance. Patients with isolated low gait speed exhibited a general trend for worse quality of life than those with isolated low handgrip strength. Gait speed and handgrip strength showed very weak correlations with different determining factors (older age, the presence of diabetes, and lower serum albumin level for low gait speed, and lower body mass index and the presence of previous cardiovascular events for low handgrip strength). Patients with low gait speed and handgrip strength had elevated levels of plasma endocan and matrix metalloproteinase-7 and the highest risks for all-cause mortality and cardiovascular events among the groups (adjusted hazard ratio of 2.72, p = 0.024). Elderly patients with low gait speed and handgrip strength were at the highest risk for poor clinical outcomes.Conclusion Gait speed and handgrip strength reflected distinctive aspects of patient characteristics and the use of both factors improved the prediction of adverse clinical outcomes in hemodialysis patients. Gait speed seems to be a better indicator of poor patient outcomes than is handgrip strength.

scholarly journals Efficacy and Safety of Expanded Hemodialysis with the Theranova 400 Dialyzer

2020 ◽  
Vol 15 (9) ◽  
pp. 1310-1319 ◽  
Author(s):  
Daniel E. Weiner ◽  
Luke Falzon ◽  
Line Skoufos ◽  
Angelito Bernardo ◽  
Werner Beck ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Serum Albumin Level ◽  
Albumin Level ◽  
Reduction Ratio ◽  
Light Chains ◽  
Maintenance Hemodialysis ◽  
High Flux ◽  
Efficacy And Safety ◽  
End Point ◽  
Middle Molecules

Background and objectivesExpanded hemodialysis therapy enabled by medium cut-off membranes may promote greater clearance of larger middle molecules that comprise putative uremic solutes than conventional high-flux dialysis. This randomized trial evaluated the efficacy and safety of hemodialysis treatment with a medium cut-off dialyzer.Design, setting, participants, & measurementsClinically stable patients on maintenance hemodialysis were randomized to receive dialysis with either a medium cut-off dialyzer (Theranova 400) or a high-flux dialyzer (Elisio-17H) over 24 weeks of treatment. The primary safety end point was the predialysis serum albumin level after 24 weeks of treatment. The primary efficacy end point was the reduction ratio of free λ light chains at 24 weeks of treatment.ResultsAmong 172 patients on maintenance hemodialysis, mean age was 59±13 years, 61% were men, 40% were Black, and mean dialysis vintage was 5±4 years. Of the 86 patients randomized to each dialyzer, 65 completed the trial in each group. The reduction ratio for the removal of free λ light chains was significantly higher in the Theranova 400 group compared with the Elisio-17H group after 4 weeks (39% versus 20%) and 24 weeks (33% versus 17%; both P<0.001). Among secondary end points, the Theranova 400 group demonstrated significantly larger reduction ratios at 4 and 24 weeks for complement factor D, free κ light chains, TNFα, and β2-microglobulin (P<0.001 for all), but not for IL-6. Predialysis serum albumin levels were similar between groups after 24 weeks (4 g/dl with the Theranova 400 and 4.1 g/dl with the Elisio-17H), consistent with noninferiority of the Theranova 400 dialyzer in maintaining predialysis serum albumin levels after 24 weeks of treatment.ConclusionsHemodialysis therapy with the Theranova 400 dialyzer provides superior removal of larger middle molecules, as exemplified by free λ light chains, compared with a similar size high-flux dialyzer, while maintaining serum albumin level.Clinical Trial registry name and registration numberA Multi-Center, Prospective, Randomized, Controlled, Open-Label, Parallel Study to Evaluate the Safety and Efficacy of the Theranova 400 Dialyzer in End Stage Renal Disease (ESRD) Patients, NCT03257410.

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