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Kidney Week

Abstract: FR-PO442

High Variability of Serum Albumin Is Associated with Increased Risk of All-Cause Mortality in Patients on Peritoneal Dialysis

Session Information

  • Home Dialysis - 1
    October 25, 2024 | Location: Exhibit Hall, Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Afghahi, Hanri, Skaraborgs Sjukhus Skovde, Skovde, Västra Götaland, Sweden
  • Nasic, Salmir, Skaraborgs Sjukhus Skovde, Skovde, Västra Götaland, Sweden
  • Peters, Björn, Skaraborgs Sjukhus Skovde, Skovde, Västra Götaland, Sweden
  • Wärme, Anna, Skaraborgs Sjukhus Skovde, Skovde, Västra Götaland, Sweden
  • Rydell, Helena, Karolinska Institutet, Stockholm, Stockholm, Sweden
  • Svensson, Maria K., Uppsala Universitet, Uppsala, Sweden
Background

Studies that evaluated trends in serum albumin and the association between variability of serum albumin and risk of all-cause mortality with peritoneal dialysis (PD) are limited.
Aim : The association between variability of serum albumin and the risk of all-cause mortality in patients on maintenance PD.

Methods

2567 patients with end-stage kidney disease (ESKD) on maintenance PD treatment were followed for mean 3.9±3.5 years by data from the Swedish Renal Register (SRR), .

The variability of serum albumin was defined as the coefficient of variation (CV) and the ratio between the standard deviation (SD) and mean value, (SD/mean). The patients were divided in four groups depending on variability of serum albumin.

The relationships between serum albumin variability and all-cause mortality were examined by univariable and multivariable Cox regression models and hazard ratios (HR) with 95% confidence intervals (CI) which was adjusted for demographics, laboratory findings, and comorbidities as well as mean value of serum albumin during the study. Lowest serum albumin variability (CV<0.05) was used as reference group for calculation of HR.

Results

During the study period 1144 (45%) deaths occurred.

The highest risk of mortality was observed in patients with highest serum albumin variability (CV>0.15) and 59% (237/399) died.
Lowest serum albumin variability (CV<0.05) had the best survival and in this group only 42% (303/718) died.

In the multivariate analyses, the two groups with the highest serum albumin variability (0.10<CV≤0.15 and CV>0.15) had a significantly increased risk of mortality (HR 1.20, 95% CI 1.002-1.44, p-value=0.048 and HR 1.55, 95% CI 1.27-1.87, p-value<0.001) , compared to reference group.

Conclusion

In patients with ESKD and PD high serum albumin variability is associated with increased risk of mortality independent of serum albumin level.

Serum albumin variability may be an important risk factor for all-cause mortality in these patients.