Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients
Background: Nutrition and inflammation have been implicated in predicting mortality in patients on peritoneal dialysis (PD). Serum albumin and globulin can be regarded for the nutritional and inflammatory status. However, there is lack of data to evaluate the synergistic effect of albumin and globul...
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MDPI AG
2022-07-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/14/14/2850 |
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| author | Kuan-Ju Lai Yao-Peng Hsieh Ping-Fang Chiu Pei-Ru Lin |
| author_facet | Kuan-Ju Lai Yao-Peng Hsieh Ping-Fang Chiu Pei-Ru Lin |
| author_sort | Kuan-Ju Lai |
| collection | DOAJ |
| description | Background: Nutrition and inflammation have been implicated in predicting mortality in patients on peritoneal dialysis (PD). Serum albumin and globulin can be regarded for the nutritional and inflammatory status. However, there is lack of data to evaluate the synergistic effect of albumin and globulin on mortality prediction. Methods: In 554 patients initiating PD from January 2001 to July 2016, we divided them into four groups by the combination of two categories of low vs. high albumin and low vs. high globulin. The median values for albumin and globulin were chosen to classify them into low or high groups. Their associations with all-cause and cardiovascular (CV) mortality were examined in Cox regression models adjusted for confounding clinical and laboratory data. Results: Patients, 52.91 ± 15.2 years old and 47.8% men, had a median (interquartile range) value of 3.3 (2.9–3.8) g/dL for albumin and 2.8 (2.5–3.2) g/dL for globulin, respectively. Patients with low albumin and high globulin had the highest all-cause mortality and CV mortality, with adjusted hazard ratios of 3.87 (95% CI 1.83–8.20, <i>p</i> < 0.001) and 5.65 (95% CI 2.23–14.34, <i>p</i> < 0.001), respectively, compared with those with a high albumin and low globulin having the lowest mortality rate. Sensitivity analyses further confirmed this relationship. Conclusions: A patient profile of either low albumin or high globulin is linked to a higher risk for mortality, particularly for a profile of both low albumin and high globulin compared with one without either of them. Further studies are needed to explore the mechanisms underlying this phenomenon and how to improve clinical outcomes in those high-risk patients. |
| first_indexed | 2024-03-09T06:05:26Z |
| format | Article |
| id | doaj.art-73dc44d43c7e41409df7b79202a8a97d |
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| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-09T06:05:26Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-73dc44d43c7e41409df7b79202a8a97d2023-12-03T12:04:06ZengMDPI AGNutrients2072-66432022-07-011414285010.3390/nu14142850Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis PatientsKuan-Ju Lai0Yao-Peng Hsieh1Ping-Fang Chiu2Pei-Ru Lin3Department of Internal Medicine, Changhua Christian Hospital, Changhua 50006, TaiwanDepartment of Internal Medicine, Division of Nephrology, Changhua Christian Hospital, Changhua 50006, TaiwanDepartment of Internal Medicine, Division of Nephrology, Changhua Christian Hospital, Changhua 50006, TaiwanBig Data Center, Changhua Christian Hospital, Changhua 50006, TaiwanBackground: Nutrition and inflammation have been implicated in predicting mortality in patients on peritoneal dialysis (PD). Serum albumin and globulin can be regarded for the nutritional and inflammatory status. However, there is lack of data to evaluate the synergistic effect of albumin and globulin on mortality prediction. Methods: In 554 patients initiating PD from January 2001 to July 2016, we divided them into four groups by the combination of two categories of low vs. high albumin and low vs. high globulin. The median values for albumin and globulin were chosen to classify them into low or high groups. Their associations with all-cause and cardiovascular (CV) mortality were examined in Cox regression models adjusted for confounding clinical and laboratory data. Results: Patients, 52.91 ± 15.2 years old and 47.8% men, had a median (interquartile range) value of 3.3 (2.9–3.8) g/dL for albumin and 2.8 (2.5–3.2) g/dL for globulin, respectively. Patients with low albumin and high globulin had the highest all-cause mortality and CV mortality, with adjusted hazard ratios of 3.87 (95% CI 1.83–8.20, <i>p</i> < 0.001) and 5.65 (95% CI 2.23–14.34, <i>p</i> < 0.001), respectively, compared with those with a high albumin and low globulin having the lowest mortality rate. Sensitivity analyses further confirmed this relationship. Conclusions: A patient profile of either low albumin or high globulin is linked to a higher risk for mortality, particularly for a profile of both low albumin and high globulin compared with one without either of them. Further studies are needed to explore the mechanisms underlying this phenomenon and how to improve clinical outcomes in those high-risk patients.https://www.mdpi.com/2072-6643/14/14/2850albuminglobulinperitoneal dialysis (PD)cardiovascular diseasechronic kidney diseasemortality |
| spellingShingle | Kuan-Ju Lai Yao-Peng Hsieh Ping-Fang Chiu Pei-Ru Lin Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients Nutrients albumin globulin peritoneal dialysis (PD) cardiovascular disease chronic kidney disease mortality |
| title | Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients |
| title_full | Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients |
| title_fullStr | Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients |
| title_full_unstemmed | Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients |
| title_short | Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients |
| title_sort | association of albumin and globulin with mortality risk in incident peritoneal dialysis patients |
| topic | albumin globulin peritoneal dialysis (PD) cardiovascular disease chronic kidney disease mortality |
| url | https://www.mdpi.com/2072-6643/14/14/2850 |
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