Association of preoperative hypoalbuminemia with postoperative acute kidney injury in patients undergoing brain tumor surgery: a retrospective study

2018 ◽  
Vol 128 (4) ◽  
pp. 1115-1122 ◽  
Author(s):  
Kyungmi Kim ◽  
Ji-Yeon Bang ◽  
Seon-Ok Kim ◽  
Saegyeol Kim ◽  
Joung Uk Kim ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Brain Tumor ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Kidney Injury ◽  
Albumin Level ◽  
Tumor Surgery ◽  
Brain Tumor Surgery ◽  
Preoperative Serum ◽  
Postoperative Aki

OBJECTIVEHypoalbuminemia is known to be independently associated with postoperative acute kidney injury (AKI). However, little is known about the association between the preoperative serum albumin level and postoperative AKI in patients undergoing brain tumor surgery. The authors investigated the incidence of AKI, impact of preoperative serum albumin level on postoperative AKI, and death in patients undergoing brain tumor surgery.METHODSThe authors retrospectively reviewed the electronic medical records and laboratory results of 2363 patients who underwent brain tumor surgery between January 2008 and December 2014. Postoperative AKI was defined according to Kidney Disease: Improving Global Outcomes Definition and Staging (KDIGO). Multivariate logistic regression analysis was used to identify demographic, preoperative laboratory, and intraoperative factors associated with AKI development. Cox proportional hazards models were used to investigate the adjusted odds ratio and hazard ratio for the association between preoperative serum albumin level and outcome variables.RESULTSThe incidence of AKI was 1.8% (n = 43) using KDIGO criteria. The incidence of AKI was higher in patients with a preoperative serum albumin level < 3.8 g/dl (3.5%) than in those with a preoperative serum albumin level ≥ 3.8 g/dl (1.2%, p < 0.001). The overall mortality was also higher in the former than in the latter group (5.0% vs 1.8%, p < 0.001). After inverse probability of treatment-weighting adjustment, a preoperative serum albumin level < 3.8 g/dl was also found to be associated with postoperative AKI (OR 1.981, 95% CI 1.022–3.841; p = 0.043) and death (HR 2.726, 95% CI 1.522–4.880; p = 0.001).CONCLUSIONSThe authors’ results demonstrated that a preoperative serum albumin level of < 3.8 g/dl was independently associated with AKI and mortality in patients undergoing brain tumor surgery.

scholarly journals Preoperative hypoalbuminemia was associated with acute kidney injury in high risk patients following non-cardiac surgery: a retrospective cohort study

2019 ◽  
Author(s):  
Nan Li ◽  
Hong Qiao ◽  
Jing-Fei Guo ◽  
Hong-Yun Yang ◽  
Xue-Ying Li ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Kidney Injury ◽  
Albumin Level ◽  
Multivariate Logistic Regression ◽  
Preoperative Serum ◽  
Postoperative Aki

Abstract Background Acute kidney injury (AKI) is a common complication following non-cardiac surgery with adverse short and long term prognosis. Current evidence have shown hypoalbuminemia was associated with an increased risk of AKI in patients with infectious diseases, cancer, following cardiac surgery and transplant surgery. However, there were few evidence focusing on non-cardiac surgery population. The purpose of this study was to investigate the association between preoperative hypoalbuminemia and AKI following non-cardiac surgery. Methods We retrospectively assessed perioperative risk factors and preoperative serum albumin in 729 consecutive adult patients who underwent non-cardiac surgery from July 1, 2017 to June 30, 2018. Each patient was categorized by maximal Kidney Disease Improving Global Outcomes criteria based on creatinine changes and urine output within first week after surgery. Multivariate Logistic regression models were used to analyze the association between preoperative hypoalbuminemia and postoperative AKI. Results Of the 729 patients, 188 (25.8%) developed AKI, the AKI incidence was higher in patients with a preoperative serum albumin level < 37.5g/L than those ≥37.5g/L [35.9% (98/273) vs. 19.7% (90/456), P <0.001]. Multivariate Logistic regression analysis showed preoperative serum albumin level < 37.5g/L (OR 1.892; 95% CI 1.238-2.891; P = 0.003) was independently associated with postoperative AKI. Furthermore, AKI in patients with preoperative hypoalbuminemia was more severe with 28.6% vs 18.0% for stage 1 (P=0.001), 2.6% vs 1.1% for stage 2 (P=0.144) and 4.8% vs 0.7% for stage 3 (P<0.001), respectively. Patients with AKI had a higher in-hospital mortality rate [6.9% (13/188) vs. 0.2% (1/541), P <0.001]. By Kaplan-Meier analysis, patients with AKI had lower cumulative survival rate with more severe stage of AKI relating to poorer outcomes (P<0.001). Postoperative AKI was also associated with other worse outcomes, such as prolonged mechanical ventilation [53.4 (33.0, 73.8) vs 14.7 (11.1, 18.3) hours, P<0.001], ICU stay [4.0 (3.1, 4.9) vs 2.0 (1.8, 2.3) days, P<0.001] and postoperative hospital stay [17.8 (14.8, 20.9) vs 12.3 (11.3, 13.3) days, P<0.001], and higher total cost [89,000 (56,000, 132,000) vs 75,000 (42,000, 109,000) yuan, P<0.001]. Conclusions Preoperative hypoalbuminemia was independently associated with AKI after non-cardiac surgery, and postoperative AKI was associated with poor outcomes.

scholarly journals Clinical significance of hypoalbuminemia in patients with scrub typhus complicated by acute kidney injury

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247584
Author(s):  
Ju Hwan Oh ◽  
Ji Hye Lim ◽  
A. Young Cho ◽  
Kwang Young Lee ◽  
In O. Sun
Keyword(s):  
Acute Kidney Injury ◽  
Serum Albumin ◽  
Clinical Significance ◽  
Serum Albumin Level ◽  
Total Bilirubin ◽  
Scrub Typhus ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Albumin Level ◽  
Multivariate Logistic Regression

Background This study aimed to investigate the clinical significance of hypoalbuminemia (HA) in patients with scrub typhus complicated by acute kidney injury (AKI). Methods From 2009 to 2018, 611 patients were diagnosed with scrub typhus. We divided the patients into two groups [normoalbuminemia (NA) vs. HA] based on the serum albumin level of 3.0 g/dL and compared the incidence, clinical characteristics, and severity of AKI based on the RIFLE classification between the two groups. Results Of the total 611 patients, 78 (12.8%) were categorized into the HA group. Compared to patients in the NA group, patients in the HA group were older (73 ± 9 vs. 62 ± 14 years, P<0.001). The HA group had a significantly longer hospital stay (9.6 ± 6.2 vs 6.2 ± 3.1 days, p<0.001) and a higher incidence of complications in respiratory and cardiovascular systems. Furthermore, AKI developed significantly more in patients in the HA group (58% vs. 18%, p<0.001) as compared to the NA group. The overall incidence of AKI was 23.1%; of which, 14.9%, 7.0%, and 1.2% of cases were classified as Risk, Injury, and Failure, respectively. The serum albumin level correlated with AKI severity (3.4 ± 0.5 vs 3.0 ± 0.5 vs 2.6 ± 0.3, p<0.05). In a multivariate logistic regression analysis for predicting AKI, age, presence of co-morbidities such as chronic kidney disease, total bilirubin, leukocytosis, and hypoalbuminemia were significant predictors for AKI. Conclusion Serum albumin level is helpful to predict the development and severity of scrub typhus-associated AKI.

scholarly journals Preoperative hypoalbuminemia was associated with acute kidney injury in high-risk patients following non-cardiac surgery: a retrospective cohort study

2019 ◽  
Author(s):  
Nan Li ◽  
Hong Qiao ◽  
Jing-Fei Guo ◽  
Hong-Yun Yang ◽  
Xue-Ying Li ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Serum Albumin ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Albumin Concentration ◽  
Multivariate Logistic Regression ◽  
Preoperative Serum ◽  
Postoperative Aki

Abstract Background: Acute kidney injury (AKI) is a common complication following non-cardiac surgery with adverse short- and long- term morbidity and mortality. Evidence shows that hypoalbuminemia is associated with increased AKI risk in patients with infectious diseases and cancer and following cardiac surgery and transplant surgery. However, little evidence is available on non-cardiac surgery population. Thus, we investigated the association between preoperative hypoalbuminemia and AKI following non-cardiac surgery. Methods: We retrospectively assessed perioperative risk factors and preoperative serum albumin concentration in 729 consecutive adult patients who underwent non-cardiac surgery from July 1, 2017, to June 30, 2018. Each patient was categorized according to maximal Kidney Disease Improving Global Outcomes criteria based on creatinine changes and urine output within the first week after surgery. Multivariate Logistic regression models were used to analyze the association between preoperative hypoalbuminemia and postoperative AKI. Results: Of 729 patients, 188 (25.8%) developed AKI. AKI incidence was higher in patients with preoperative serum albumin <37.5 g/L than in those with preoperative serum albumin ≥37.5 g/L [35.9% (98/273) vs. 19.7% (90/456), P<0.001]. Multivariate logistic regression analysis showed that preoperative serum albumin <37.5 g/L (odds ratio 1.892; 95% confidence interval 1.238-2.891; P=0.003) was independently associated with postoperative AKI. Patients with preoperative serum albumin <37.5 g/L tended to have a higher but not significant ratio in AKI stage 2 (2.6% vs 1.1%, P=0.144) and much higher ratio in AKI stage 3 (4.8% vs 0.7%, P<0.001) than those with preoperative serum albumin ≥37.5 g/L. AKI patients had a higher in-hospital mortality rate [6.9% (13/188) vs. 0.2% (1/541), P<0.001]. Kaplan-Meier analysis revealed that the cumulative survival rate decreased with increasing AKI severity (P<0.001). Postoperative AKI was also associated with other worse outcomes, such as prolonged mechanical ventilation [53.4 (33.0, 73.8) vs 14.7 (11.1, 18.3) hours, P<0.001], intensive care unit stay [4.0 (3.1, 4.9) vs 2.0 (1.8, 2.3) days, P<0.001], postoperative hospital stay [17.8 (14.8, 20.9) vs 12.3 (11.3, 13.3) days, P<0.001], and higher total cost [13,453 (8,538, 20,228) vs 11,306 (6,277, 16,400) dollars, P<0.001]. Conclusions: Preoperative hypoalbuminemia was independently associated with AKI after non-cardiac surgery, and postoperative AKI was associated with poor outcomes.

scholarly journals U-shape association of serum albumin level and acute kidney injury risk in hospitalized patients

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0199153 ◽  
Author(s):  
Charat Thongprayoon ◽  
Wisit Cheungpasitporn ◽  
Michael A. Mao ◽  
Ankit Sakhuja ◽  
Kianoush Kashani
Keyword(s):  
Acute Kidney Injury ◽  
Serum Albumin ◽  
Injury Risk ◽  
Serum Albumin Level ◽  
Kidney Injury ◽  
Albumin Level ◽  
Hospitalized Patients

scholarly journals Preoperative hypoalbuminemia was associated with acute kidney injury in high-risk patients following non-cardiac surgery: a retrospective cohort study

2019 ◽  
Author(s):  
Nan Li ◽  
Hong Qiao ◽  
Jing-Fei Guo ◽  
Hong-Yun Yang ◽  
Xue-Ying Li ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Serum Albumin ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Albumin Concentration ◽  
Multivariate Logistic Regression ◽  
Preoperative Serum ◽  
Postoperative Aki

Abstract Background: Acute kidney injury (AKI) is a common complication following non-cardiac surgery with adverse short- and long- term morbidity and mortality. Evidence shows that hypoalbuminemia is associated with increased AKI risk in patients with infectious diseases and cancer and following cardiac surgery and transplant surgery. However, little evidence is available on non-cardiac surgery population. Thus, we investigated the association between preoperative hypoalbuminemia and AKI following non-cardiac surgery. Methods: We retrospectively assessed perioperative risk factors and preoperative serum albumin concentration in 729 consecutive adult patients who underwent non-cardiac surgery from July 1, 2017, to June 30, 2018. Each patient was categorized according to maximal Kidney Disease Improving Global Outcomes criteria based on creatinine changes and urine output within the first week after surgery. Multivariate Logistic regression models were used to analyze the association between preoperative hypoalbuminemia and postoperative AKI. Results: Of 729 patients, 188 (25.8%) developed AKI. AKI incidence was higher in patients with preoperative serum albumin <37.5 g/L than in those with preoperative serum albumin ≥37.5 g/L [35.9% (98/273) vs. 19.7% (90/456), P<0.001]. Multivariate logistic regression analysis showed that preoperative serum albumin <37.5 g/L (odds ratio 1.892; 95% confidence interval 1.238-2.891; P=0.003) was independently associated with postoperative AKI. Patients with preoperative serum albumin <37.5 g/L tended to have a higher but not significant ratio in AKI stage 2 (2.6% vs 1.1%, P=0.144) and much higher ratio in AKI stage 3 (4.8% vs 0.7%, P<0.001) than those with preoperative serum albumin ≥37.5 g/L. AKI patients had a higher in-hospital mortality rate [6.9% (13/188) vs. 0.2% (1/541), P<0.001]. Kaplan-Meier analysis revealed that the cumulative survival rate decreased with increasing AKI severity (P<0.001). Postoperative AKI was also associated with other worse outcomes, such as prolonged mechanical ventilation [53.4 (33.0, 73.8) vs 14.7 (11.1, 18.3) hours, P<0.001], intensive care unit stay [4.0 (3.1, 4.9) vs 2.0 (1.8, 2.3) days, P<0.001], postoperative hospital stay [17.8 (14.8, 20.9) vs 12.3 (11.3, 13.3) days, P<0.001], and higher total cost [13,453 (8,538, 20,228) vs 11,306 (6,277, 16,400) dollars, P<0.001]. Conclusions Preoperative hypoalbuminemia was independently associated with AKI after non-cardiac surgery, and postoperative AKI was associated with poor outcomes.

scholarly journals Impact of the serum albumin level on acute kidney injury after cerebral artery aneurysm clipping

PLoS ONE ◽  
2018 ◽  
Vol 13 (11) ◽  
pp. e0206731 ◽  
Author(s):  
Ji -Yeon Bang ◽  
Seon-Ok Kim ◽  
Sae-Gyeol Kim ◽  
Jun-Gol Song ◽  
Jiwon Kang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Albumin ◽  
Cerebral Artery ◽  
Serum Albumin Level ◽  
Kidney Injury ◽  
Artery Aneurysm ◽  
Albumin Level ◽  
Aneurysm Clipping ◽  
Cerebral Artery Aneurysm

scholarly journals Serum albumin level as a predictor of contrast-induced acute kidney injury following coronary angiography

2020 ◽  
Vol 5 (1) ◽  
pp. 29-34
Author(s):  
Jayakumar Sreenivasan ◽  
Muhammad Khan ◽  
Qiyu Wang ◽  
Sagar Ranka ◽  
Tauseef Akhtar ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Coronary Angiography ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Kidney Injury ◽  
Albumin Level

Preoperative Low Serum Albumin Levels Increase the Requirement of Renal Replacement Therapy after Cardiac Surgery

2016 ◽  
Vol 19 (3) ◽  
pp. 123 ◽  
Author(s):  
Orhan Findik ◽  
Ufuk Aydin ◽  
Ozgur Baris ◽  
Hakan Parlar ◽  
Gokcen Atilboz Alagoz ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Regression Analysis ◽  
Cardiac Surgery ◽  
Renal Replacement Therapy ◽  
Serum Albumin ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Preoperative Serum ◽  
Group I ◽  
Group Ii

<strong>Background:</strong> Acute kidney injury is a common complication of cardiac surgery that increases morbidity and mortality. The aim of the present study is to analyze the association of preoperative serum albumin levels with acute kidney injury and the requirement of renal replacement therapy after isolated coronary artery bypass graft surgery (CABG).<br /><strong>Methods:</strong> We retrospectively reviewed the prospectively collected data of 530 adult patients who underwent isolated CABG surgery with normal renal function. The perioperative clinical data of the patients included demographic data, laboratory data, length of stay, in-hospital complications and mortality. The patient population was divided into two groups: group I patients with preoperative serum albumin levels &lt;3.5 mg/dL; and group II pateints with preoperative serum albumin levels ≥3.5 mg/dL.<br /><strong>Results:</strong> There were 413 patients in group I and 117 patients in group II. Postoperative acute kidney injury (AKI) occured in 33 patients (28.2%) in group I and in 79 patients (19.1%) in group II. Renal replacement therapy was required in 17 patients (3.2%) (8 patients from group I; 9 patients from group II; P = .018). 30-day mortality occurred in 18 patients (3.4%) (10 patients from group I; 8 patients from group II; P = .037). Fourteen of these patients required renal replacement therapy. Logistic regression analysis revealing the presence of lower serum albumin levels preoperatively was shown to be associated with increased incidence of postoperative AKI (OR: 1.661; 95% CI: 1.037-2.661; <br />P = .035). Logistic regression analysis also revealed that DM (OR: 3.325; 95% CI: 2.162-5.114; P = .000) was another independent risk factor for AKI after isolated CABG. <br /><strong>Conclusion:</strong> Low preoperative serum albumin levels result in severe acute kidney injury and increase the rate of renal replacement therapy and mortality after isolated CABG.

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