Low serum albumin as a risk factor for infection-related in-hospital death among hemodialysis patients hospitalized on suspicion of infectious disease: a Japanese multicenter retrospective cohort study
Abstract Background Serum albumin is a marker of nourishment and inflammation. Although hypoalbuminemia in hemodialysis patients is reported as a risk factor for poor prognosis, few studies describe its effects on infectious diseases specifically. This study aimed to examine the relationship between...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-08-01
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| Series: | Renal Replacement Therapy |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s41100-018-0173-8 |
| _version_ | 1819071782333710336 |
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| author | Shun Minatoguchi Atsushi Nomura Takahiro Imaizumi Sho Sasaki Takaya Ozeki Daisuke Uchida Hiroo Kawarazaki Fumihiko Sasai Keigo Tomita Hideaki Shimizu Yoshiro Fujita |
| author_facet | Shun Minatoguchi Atsushi Nomura Takahiro Imaizumi Sho Sasaki Takaya Ozeki Daisuke Uchida Hiroo Kawarazaki Fumihiko Sasai Keigo Tomita Hideaki Shimizu Yoshiro Fujita |
| author_sort | Shun Minatoguchi |
| collection | DOAJ |
| description | Abstract Background Serum albumin is a marker of nourishment and inflammation. Although hypoalbuminemia in hemodialysis patients is reported as a risk factor for poor prognosis, few studies describe its effects on infectious diseases specifically. This study aimed to examine the relationship between the serum albumin level on admission and infection-related in-hospital death among hemodialysis patients. Methods This was a multicenter retrospective observational study that was undertaken in Japan. We reviewed the medical records of 507 hemodialysis patients aged > 18 years, whose blood cultures were obtained based on suspicion of infectious disease, and who were managed at seven Japanese tertiary dialysis units from August 2011 to July 2013. The outcome measure was infection-related in-hospital death. Multivariate logistic regression models adjusted for age, sex, the dialysis vintage, diabetes mellitus, bacteremia, and log C-reactive protein levels were used for the statistical analysis. Results Four hundred patients were analyzed and allocated to three groups based on their serum albumin levels: marked hypoalbuminemia (< 2.5 mg/dL), mild hypoalbuminemia (≤ 2.5–< 3.5 mg/dL), and normal albumin levels (≤ 3.5 mg/dL). The infection-related in-hospital death rates were 22.9% (n = 11), 12.5% (n = 25), and 4.6% (n = 7), respectively. The multivariate logistic regression models determined that a low serum albumin level was an independent risk factor for infection-related in-hospital death (odds ratio 0.35, 95% confidence interval 0.18–0.66). Conclusions A low serum albumin level strongly predicts infection-related in-hospital death in hemodialysis patients hospitalized on suspicion of infection. Like those with bacteremia or diabetes mellitus, hemodialysis patients with hypoalbuminemia require careful management of their infections. |
| first_indexed | 2024-12-21T17:27:18Z |
| format | Article |
| id | doaj.art-95f7ce39953c4c73a4f0d3cbd3a63751 |
| institution | Directory Open Access Journal |
| issn | 2059-1381 |
| language | English |
| last_indexed | 2024-12-21T17:27:18Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Renal Replacement Therapy |
| spelling | doaj.art-95f7ce39953c4c73a4f0d3cbd3a637512022-12-21T18:56:01ZengBMCRenal Replacement Therapy2059-13812018-08-01411710.1186/s41100-018-0173-8Low serum albumin as a risk factor for infection-related in-hospital death among hemodialysis patients hospitalized on suspicion of infectious disease: a Japanese multicenter retrospective cohort studyShun Minatoguchi0Atsushi Nomura1Takahiro Imaizumi2Sho Sasaki3Takaya Ozeki4Daisuke Uchida5Hiroo Kawarazaki6Fumihiko Sasai7Keigo Tomita8Hideaki Shimizu9Yoshiro Fujita10Department of Nephrology, Chubu Rosai HospitalDepartment of Nephrology, Chubu Rosai HospitalDepartment of Nephrology, Chubu Rosai HospitalDivision of Nephrology and Hypertension, St. Marianna University School of Medicine HospitalDepartment of Nephrology, Nagoya University Graduate School of MedicineDepartment of Nephrology and Hypertension, Kawasaki Municipal Tama HospitalDepartment of Nephrology, Inagi Municipal HospitalDepartment of Nephrology, Showa University Fujigaoka HospitalDepartment of Nephrology, Iizuka HospitalDepartment of Nephrology, Chubu Rosai HospitalDepartment of Nephrology, Chubu Rosai HospitalAbstract Background Serum albumin is a marker of nourishment and inflammation. Although hypoalbuminemia in hemodialysis patients is reported as a risk factor for poor prognosis, few studies describe its effects on infectious diseases specifically. This study aimed to examine the relationship between the serum albumin level on admission and infection-related in-hospital death among hemodialysis patients. Methods This was a multicenter retrospective observational study that was undertaken in Japan. We reviewed the medical records of 507 hemodialysis patients aged > 18 years, whose blood cultures were obtained based on suspicion of infectious disease, and who were managed at seven Japanese tertiary dialysis units from August 2011 to July 2013. The outcome measure was infection-related in-hospital death. Multivariate logistic regression models adjusted for age, sex, the dialysis vintage, diabetes mellitus, bacteremia, and log C-reactive protein levels were used for the statistical analysis. Results Four hundred patients were analyzed and allocated to three groups based on their serum albumin levels: marked hypoalbuminemia (< 2.5 mg/dL), mild hypoalbuminemia (≤ 2.5–< 3.5 mg/dL), and normal albumin levels (≤ 3.5 mg/dL). The infection-related in-hospital death rates were 22.9% (n = 11), 12.5% (n = 25), and 4.6% (n = 7), respectively. The multivariate logistic regression models determined that a low serum albumin level was an independent risk factor for infection-related in-hospital death (odds ratio 0.35, 95% confidence interval 0.18–0.66). Conclusions A low serum albumin level strongly predicts infection-related in-hospital death in hemodialysis patients hospitalized on suspicion of infection. Like those with bacteremia or diabetes mellitus, hemodialysis patients with hypoalbuminemia require careful management of their infections.http://link.springer.com/article/10.1186/s41100-018-0173-8AlbuminDialysisHypoalbuminemiaInfectionMortality |
| spellingShingle | Shun Minatoguchi Atsushi Nomura Takahiro Imaizumi Sho Sasaki Takaya Ozeki Daisuke Uchida Hiroo Kawarazaki Fumihiko Sasai Keigo Tomita Hideaki Shimizu Yoshiro Fujita Low serum albumin as a risk factor for infection-related in-hospital death among hemodialysis patients hospitalized on suspicion of infectious disease: a Japanese multicenter retrospective cohort study Renal Replacement Therapy Albumin Dialysis Hypoalbuminemia Infection Mortality |
| title | Low serum albumin as a risk factor for infection-related in-hospital death among hemodialysis patients hospitalized on suspicion of infectious disease: a Japanese multicenter retrospective cohort study |
| title_full | Low serum albumin as a risk factor for infection-related in-hospital death among hemodialysis patients hospitalized on suspicion of infectious disease: a Japanese multicenter retrospective cohort study |
| title_fullStr | Low serum albumin as a risk factor for infection-related in-hospital death among hemodialysis patients hospitalized on suspicion of infectious disease: a Japanese multicenter retrospective cohort study |
| title_full_unstemmed | Low serum albumin as a risk factor for infection-related in-hospital death among hemodialysis patients hospitalized on suspicion of infectious disease: a Japanese multicenter retrospective cohort study |
| title_short | Low serum albumin as a risk factor for infection-related in-hospital death among hemodialysis patients hospitalized on suspicion of infectious disease: a Japanese multicenter retrospective cohort study |
| title_sort | low serum albumin as a risk factor for infection related in hospital death among hemodialysis patients hospitalized on suspicion of infectious disease a japanese multicenter retrospective cohort study |
| topic | Albumin Dialysis Hypoalbuminemia Infection Mortality |
| url | http://link.springer.com/article/10.1186/s41100-018-0173-8 |
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