Pretransplant C-reactive protein-to-albumin ratio predicts mortality in kidney transplant recipients: a retrospective cohort study
Background : The C-reactive protein (CRP)-to-albumin ratio (CAR) is a more effective prognostic indicator than CRP or albumin alone in various diseases. This study aimed to evaluate the predictive value of the CAR for mortality in kidney transplant recipients (KTRs). Methods : A total of 924 patient...
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| Format: | Article |
| Language: | English |
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Korean Society for Transplantation
2023-03-01
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| Series: | Korean Journal of Transplantation |
| Subjects: | |
| Online Access: | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.22.0047 |
| _version_ | 1827392294695731200 |
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| author | Jae Wan Kwon Yena Jeon Hee-Yeon Jung Ji-Young Choi Sun-Hee Park Chan-Duck Kim Yong-Lim Kim Deokbi Hwang Woo-Sung Yun Hyung-Kee Kim Seung Huh Eun Sang Yoo Dong-Il Won Jang-Hee Cho Jeong-Hoon Lim |
| author_facet | Jae Wan Kwon Yena Jeon Hee-Yeon Jung Ji-Young Choi Sun-Hee Park Chan-Duck Kim Yong-Lim Kim Deokbi Hwang Woo-Sung Yun Hyung-Kee Kim Seung Huh Eun Sang Yoo Dong-Il Won Jang-Hee Cho Jeong-Hoon Lim |
| author_sort | Jae Wan Kwon |
| collection | DOAJ |
| description | Background : The C-reactive protein (CRP)-to-albumin ratio (CAR) is a more effective prognostic indicator than CRP or albumin alone in various diseases. This study aimed to evaluate the predictive value of the CAR for mortality in kidney transplant recipients (KTRs). Methods : A total of 924 patients who underwent their f irst kidney transplantation at Kyungpook National University Hospital during 2006–2020 were enrolled and classified into quartile (Q) groups according to their pretransplant CAR values. A Cox regression analysis was conducted to analyze the hazard ratios (HRs) of mortality. Results : Fifty-nine patients died during the posttransplant period (mean, 85.2±44.2 months). All-cause mortality (Q1, 3.0%; Q2, 4.8%; Q3, 7.8%; Q4, 10.0%; P for trend <0.001) and infection-related mortality increased linearly with an increase in CAR (P for trend=0.004). The Q3 and Q4 had higher risks of all-cause mortality than Q1 after adjusting for confounding factors (Q3: adjusted HR [aHR] 2.49, 95% confidence interval [CI] 1.04–5.99, P=0.041; Q4: aHR 3.09, 95% CI 1.31–7.27, P=0.010). Q4 was also independently associated with infection-related mortality (aHR 5.83, 95% CI 1.27–26.8, P=0.023). The area under the curve of the CAR for all-cause and infection-related mortality was higher than that of CRP or albumin alone. There was no association between CAR and death-censored graft failure or acute rejection. Conclusions: A higher pretransplant CAR increases the risk of posttransplant mortality, particularly infection-related, in KTRs. Pretransplant CAR can be an effective and easily accessible predictor of posttransplant mortality. |
| first_indexed | 2024-03-08T17:29:09Z |
| format | Article |
| id | doaj.art-d21723174b574152a1608c5d7e0a64cf |
| institution | Directory Open Access Journal |
| issn | 2671-8790 |
| language | English |
| last_indexed | 2024-03-08T17:29:09Z |
| publishDate | 2023-03-01 |
| publisher | Korean Society for Transplantation |
| record_format | Article |
| series | Korean Journal of Transplantation |
| spelling | doaj.art-d21723174b574152a1608c5d7e0a64cf2024-01-02T17:27:16ZengKorean Society for TransplantationKorean Journal of Transplantation2671-87902023-03-01371192810.4285/kjt.22.0047kjt.22.0047Pretransplant C-reactive protein-to-albumin ratio predicts mortality in kidney transplant recipients: a retrospective cohort studyJae Wan Kwon0Yena Jeon1Hee-Yeon Jung2Ji-Young Choi3Sun-Hee Park4Chan-Duck Kim5Yong-Lim Kim6Deokbi Hwang7Woo-Sung Yun8Hyung-Kee Kim9Seung Huh10Eun Sang Yoo11Dong-Il Won12Jang-Hee Cho13Jeong-Hoon Lim14Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Pathology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Urology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Clinical Pathology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaDepartment of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, KoreaBackground : The C-reactive protein (CRP)-to-albumin ratio (CAR) is a more effective prognostic indicator than CRP or albumin alone in various diseases. This study aimed to evaluate the predictive value of the CAR for mortality in kidney transplant recipients (KTRs). Methods : A total of 924 patients who underwent their f irst kidney transplantation at Kyungpook National University Hospital during 2006–2020 were enrolled and classified into quartile (Q) groups according to their pretransplant CAR values. A Cox regression analysis was conducted to analyze the hazard ratios (HRs) of mortality. Results : Fifty-nine patients died during the posttransplant period (mean, 85.2±44.2 months). All-cause mortality (Q1, 3.0%; Q2, 4.8%; Q3, 7.8%; Q4, 10.0%; P for trend <0.001) and infection-related mortality increased linearly with an increase in CAR (P for trend=0.004). The Q3 and Q4 had higher risks of all-cause mortality than Q1 after adjusting for confounding factors (Q3: adjusted HR [aHR] 2.49, 95% confidence interval [CI] 1.04–5.99, P=0.041; Q4: aHR 3.09, 95% CI 1.31–7.27, P=0.010). Q4 was also independently associated with infection-related mortality (aHR 5.83, 95% CI 1.27–26.8, P=0.023). The area under the curve of the CAR for all-cause and infection-related mortality was higher than that of CRP or albumin alone. There was no association between CAR and death-censored graft failure or acute rejection. Conclusions: A higher pretransplant CAR increases the risk of posttransplant mortality, particularly infection-related, in KTRs. Pretransplant CAR can be an effective and easily accessible predictor of posttransplant mortality.http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.22.0047albumin; c-reactive protein; c-reactive protein-to-albumin ratio; kidney transplantation; mortality |
| spellingShingle | Jae Wan Kwon Yena Jeon Hee-Yeon Jung Ji-Young Choi Sun-Hee Park Chan-Duck Kim Yong-Lim Kim Deokbi Hwang Woo-Sung Yun Hyung-Kee Kim Seung Huh Eun Sang Yoo Dong-Il Won Jang-Hee Cho Jeong-Hoon Lim Pretransplant C-reactive protein-to-albumin ratio predicts mortality in kidney transplant recipients: a retrospective cohort study Korean Journal of Transplantation albumin; c-reactive protein; c-reactive protein-to-albumin ratio; kidney transplantation; mortality |
| title | Pretransplant C-reactive protein-to-albumin ratio predicts mortality in kidney transplant recipients: a retrospective cohort study |
| title_full | Pretransplant C-reactive protein-to-albumin ratio predicts mortality in kidney transplant recipients: a retrospective cohort study |
| title_fullStr | Pretransplant C-reactive protein-to-albumin ratio predicts mortality in kidney transplant recipients: a retrospective cohort study |
| title_full_unstemmed | Pretransplant C-reactive protein-to-albumin ratio predicts mortality in kidney transplant recipients: a retrospective cohort study |
| title_short | Pretransplant C-reactive protein-to-albumin ratio predicts mortality in kidney transplant recipients: a retrospective cohort study |
| title_sort | pretransplant c reactive protein to albumin ratio predicts mortality in kidney transplant recipients a retrospective cohort study |
| topic | albumin; c-reactive protein; c-reactive protein-to-albumin ratio; kidney transplantation; mortality |
| url | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.22.0047 |
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