Early changes in serum albumin: impact on 2-year mortality in incident hemodialysis patients

• Autor(a) principal: Pereira,Giselly Rosa Modesto
• Data de Publicação: 2015
• Outros Autores: Strogoff-de-Matos,Jorge Paulo, Ruzany,Frederico, Santos,Sergio Fernando Ferreira dos, D'Almeida Filho,Eufrônio, Vasconcelos,Marcos Sandro Fernandes de, Barra,Ana Beatriz, Lugon,Jocemir Ronaldo
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Jornal Brasileiro de Nefrologia
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002015000200198
• topic: kidney failure, chronic; mortality; renal dialysis; serum albumin

Abstract Introduction/objective: We evaluated the predictability of early changes in serum albumin (sAlb) on the two-year mortality of incident hemodialysis patients. Methods: Observational, longitudinal retrospective study using the database of Fresenius Medical Care of Latin America. Adult patients starting dialysis from January/2000 to June/2004, from 25 centers were included. Changes in sAlb during the first 3 months on hemodialysis were used as the main predictor. The outcome was death from any cause. Results: 1,679 incident patients were included. They were 52 ± 15 years old, 58.7% male and 21.5% diabetic, with a median sAlb of 38 g/L (bromocresol green). 923 patients had sAlb < 38 g/L (Low sAlb Group) and 756 ones had sAlb > 38.0 g/L (Adequate sAlb Group). The mortality was significantly higher in Low sAlb Group (17% vs. 11%, p < 0.001). Early changes in sAlb significantly affected two-year mortality. Factoring the Kaplan Meier curve of Low sAlb Group by the presence of an increase in sAlb uncovered of a statistically significant difference in mortality favoring the ones whose sAlb went up (19% vs. 15%, p = 0.043). Differently, patients from Adequate sAlb Group with a decrease in their sAlb had a statistically higher mortality rate (13% vs. 8%, p = 0.029). Conclusions: Early sAlb changes showed a significant predictive power on mortality at 2 years in incident hemodialysis patients. Those with low initial sAlb may have a better prognosis if their sAlb rises. In contrast, patients with satisfactory initial levels can have a worsening of their prognosis in the case of an early reduction in sAlb.