Serum Albumin levels can predict prognosis of patients with CKD

The deterioration in renal function and the prognosis for kidney function in Japanese chronic kidney disease (CKD) patients are negatively and non-linearly correlated, says a recent study by Tong Cheng and colleagues. The findings of this study were published in BMC Nephrology.

Worldwide, end-stage renal disease (ESRD), which can advance to chronic kidney disease (CKD), has become a serious health problem. It is linked to an increased risk of cardiovascular illness and death, with consequently high societal and financial costs. The purpose of this study is to ascertain how serum albumin and renal function decline and prognosis are related. A cohort study in the Japanese CKD community was created as a result.

This research was a secondary analysis of a prospective cohort study in which 954 individuals in total were non-selectively and continuously gathered from the CKD-ROUTE study in Japan between November 2010 and December 2011. Researchers used the Cox proportional-hazards and linear regression models, respectively, to assess the relationship between initial ALB and renal prognosis and renal function decrease (annual eGFR drop). To guarantee the accuracy of the findings, several sensitivity studies were carried out. Subgroup analyses were also conducted.

The key findings of this study were:

1. The included patients were 522 (69.23%) men with a mean age of (66.86 13.41) years. The average baseline ALB and eGFR were 3.89 0.59 and 33.43 17.97 ml/min/1.73 m2, respectively.

2. The eGFR decreased by 2.65 mL/min/1.73 m2/year on a yearly basis.

3. With a median follow-up of 36.0 months, 218 people (28.9%) were diagnosed with renal prognosis.

4. After adjusting for variables, the baseline ALB showed an inverse relationship with renal prognosis and renal function deterioration.

5. The relationship between the renal prognosis and ALB was nonlinear, with the inflection point of ALB occurring at 4.3 g/dL.

6. The effect sizes (HR) on the left and right sides of the inflection point were 0.42 (0.32, 0.56) and 6.11 (0.98, 38.22), respectively.

ALB decline was closely correlated with poor renal prognosis and renal function decline when ALB was lower than 4.1 g/dL. From a therapeutic perspective, postponing the course of CKD makes sense by slowing the drop in ALB.

Reference:

Cheng, T., Wang, X., Han, Y., Hao, J., Hu, H., & Hao, L. (2023). The level of serum albumin is associated with renal prognosis and renal function decline in patients with chronic kidney disease. In BMC Nephrology (Vol. 24, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12882-023-03110-8