Low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysis
Background: Prealbumin, a sensitive marker for protein–energy status, is also known as an independent risk factor for mortality in hemodialysis patients. We investigated the impact of prealbumin on survival in incident peritoneal dialysis (PD) patients. Methods: In total, 136 incident PD patients (m...
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| Format: | Article |
| Language: | English |
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The Korean Society of Nephrology
2016-09-01
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| Series: | Kidney Research and Clinical Practice |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211913216300134 |
| _version_ | 1819062295929552896 |
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| author | Kyung Hee Lee Jang-Hee Cho Owen Kwon Sang-Un Kim Ryang Hi Kim Young Wook Cho Hee-Yeon Jung Ji-Young Choi Chan-Duck Kim Yong-Lim Kim Sun-Hee Park |
| author_facet | Kyung Hee Lee Jang-Hee Cho Owen Kwon Sang-Un Kim Ryang Hi Kim Young Wook Cho Hee-Yeon Jung Ji-Young Choi Chan-Duck Kim Yong-Lim Kim Sun-Hee Park |
| author_sort | Kyung Hee Lee |
| collection | DOAJ |
| description | Background: Prealbumin, a sensitive marker for protein–energy status, is also known as an independent risk factor for mortality in hemodialysis patients. We investigated the impact of prealbumin on survival in incident peritoneal dialysis (PD) patients.
Methods: In total, 136 incident PD patients (mean age, 53.0 ± 15.8 years) between 2002 and 2007 were enrolled in the study. Laboratory data, dialysis adequacy, and nutritional parameters were assessed 3 months after PD initiation. Patients were classified into 2 groups according to prealbumin level: high prealbumin (≥ 40 mg/dL) and low prealbumin (< 40 mg/dL).
Results: The patients in the low-prealbumin group were older and had more comorbidities such as diabetes and cardiovascular diseases compared with the patients in the high-prealbumin group. Mean subjective global assessment scores were lower, and the high-sensitivity C-reactive protein levels were higher in the low-prealbumin group. Serum creatinine, albumin, and transferrin levels; percent lean body mass; and normalized protein catabolic rate were positively associated, whereas subjective global assessment scores and high-sensitivity C-reactive protein levels were negatively associated with prealbumin concentration. During the median follow-up of 49 months, patients in the lower prealbumin group had a higher mortality rate. Multivariate analysis revealed that prealbumin < 40 mg/dL (hazard ratio, 2.30; 95% confidence interval, 1.14–4.64) was an independent risk factor for mortality. In receiver operating characteristic curves, the area under the curve of prealbumin for mortality was the largest among the parameters.
Conclusion: Prealbumin levels were an independent and sensitive predictor for mortality in incident PD patients, showing a good correlation with nutritional and inflammatory markers. |
| first_indexed | 2024-12-21T14:56:31Z |
| format | Article |
| id | doaj.art-026b4d87c7d9481c8e16b23567c13461 |
| institution | Directory Open Access Journal |
| issn | 2211-9132 |
| language | English |
| last_indexed | 2024-12-21T14:56:31Z |
| publishDate | 2016-09-01 |
| publisher | The Korean Society of Nephrology |
| record_format | Article |
| series | Kidney Research and Clinical Practice |
| spelling | doaj.art-026b4d87c7d9481c8e16b23567c134612022-12-21T18:59:44ZengThe Korean Society of NephrologyKidney Research and Clinical Practice2211-91322016-09-0135316917510.1016/j.krcp.2016.06.002Low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysisKyung Hee Lee0Jang-Hee Cho1Owen Kwon2Sang-Un Kim3Ryang Hi Kim4Young Wook Cho5Hee-Yeon Jung6Ji-Young Choi7Chan-Duck Kim8Yong-Lim Kim9Sun-Hee Park10Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University School of Medicine, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University School of Medicine, Daegu, KoreaBackground: Prealbumin, a sensitive marker for protein–energy status, is also known as an independent risk factor for mortality in hemodialysis patients. We investigated the impact of prealbumin on survival in incident peritoneal dialysis (PD) patients. Methods: In total, 136 incident PD patients (mean age, 53.0 ± 15.8 years) between 2002 and 2007 were enrolled in the study. Laboratory data, dialysis adequacy, and nutritional parameters were assessed 3 months after PD initiation. Patients were classified into 2 groups according to prealbumin level: high prealbumin (≥ 40 mg/dL) and low prealbumin (< 40 mg/dL). Results: The patients in the low-prealbumin group were older and had more comorbidities such as diabetes and cardiovascular diseases compared with the patients in the high-prealbumin group. Mean subjective global assessment scores were lower, and the high-sensitivity C-reactive protein levels were higher in the low-prealbumin group. Serum creatinine, albumin, and transferrin levels; percent lean body mass; and normalized protein catabolic rate were positively associated, whereas subjective global assessment scores and high-sensitivity C-reactive protein levels were negatively associated with prealbumin concentration. During the median follow-up of 49 months, patients in the lower prealbumin group had a higher mortality rate. Multivariate analysis revealed that prealbumin < 40 mg/dL (hazard ratio, 2.30; 95% confidence interval, 1.14–4.64) was an independent risk factor for mortality. In receiver operating characteristic curves, the area under the curve of prealbumin for mortality was the largest among the parameters. Conclusion: Prealbumin levels were an independent and sensitive predictor for mortality in incident PD patients, showing a good correlation with nutritional and inflammatory markers.http://www.sciencedirect.com/science/article/pii/S2211913216300134InflammationNutritionPeritoneal dialysisPrealbumin |
| spellingShingle | Kyung Hee Lee Jang-Hee Cho Owen Kwon Sang-Un Kim Ryang Hi Kim Young Wook Cho Hee-Yeon Jung Ji-Young Choi Chan-Duck Kim Yong-Lim Kim Sun-Hee Park Low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysis Kidney Research and Clinical Practice Inflammation Nutrition Peritoneal dialysis Prealbumin |
| title | Low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysis |
| title_full | Low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysis |
| title_fullStr | Low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysis |
| title_full_unstemmed | Low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysis |
| title_short | Low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysis |
| title_sort | low prealbumin levels are independently associated with higher mortality in patients on peritoneal dialysis |
| topic | Inflammation Nutrition Peritoneal dialysis Prealbumin |
| url | http://www.sciencedirect.com/science/article/pii/S2211913216300134 |
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