Document Detail


One-year serum albumin is an independent predictor of outcomes in kidney transplant recipients.
MedLine Citation:
PMID:  20537920     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This research study was conducted to investigate whether serum albumin levels predict allograft/patient outcomes in the new era of transplant medicine and immunology.
METHODS: The association of 1-year post-transplant serum albumin, and patient and graft outcomes was retrospectively analyzed in 500 kidney transplant recipients between 1998 and 2005. Albumin was used as a categorical and a continuous variable in univariate and multivariate Cox regression and Kaplan-Meier survival analyses.
RESULTS: The average (±SE) age at transplant was 47 ± 12 years. Patients were followed up for 63.4 ± 28 months after transplant. There were 56 graft losses and 38 patient deaths. In univariate analysis, the following variables were associated with the composite endpoint of patient death or allograft loss: 1-year serum albumin (hazard ratio [HR] = 0.52, P = .0009), 1-year serum albumin <4.0 g/dL (HR = 1.81, P = .02), 1-year serum creatinine (HR = 3.55, P < .00001), angiotensin converting enzyme inhibitors or angiotensin receptor blockers use (HR = 1.61, P = .03), a history of previous transplant (HR = 1.54, P = .04), months of dialysis before transplant (HR = 1.01, P = .00003), type of transplant (deceased donor HR = 1.64, P = .02), and acute rejection (HR = 1.52, P = .0000003). Of these, multivariable Cox regression analyses retained 1-year serum albumin (HR = 1.4, P < .0001), serum creatinine (HR = 2.7, P < .0001), and acute rejection (HR = 1.7, P = .02) as significant predictors of patient/graft loss.
CONCLUSION: One-year serum albumin is an independent predictor of poor outcomes in the contemporary era of transplant medicine and immunosuppression. Further studies are needed to separate the role of this biomarker in inflammation and nutrition in kidney transplant recipients.
Authors:
Rebecca Dahlberg; Brenda Muth; Milagros Samaniego; R Michael Hofmann; John Pirsch; Arjang Djamali
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-05-26
Journal Detail:
Title:  Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation     Volume:  20     ISSN:  1532-8503     ISO Abbreviation:  J Ren Nutr     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-19     Completed Date:  2011-01-27     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  9112938     Medline TA:  J Ren Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  392-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Medicine, University of Wisconsin Madison SMPH, Madison, Wisconsin 53792, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiotensin Receptor Antagonists / blood
Angiotensin-Converting Enzyme Inhibitors / blood
Biological Markers
Creatinine / blood
Female
Graft Rejection / immunology,  mortality*
Graft Survival*
Humans
Kaplan-Meier Estimate
Kidney Failure, Chronic / therapy*
Kidney Transplantation / immunology*,  mortality
Male
Middle Aged
Regression Analysis
Retrospective Studies
Serum Albumin / analysis*
Transplantation, Homologous
Treatment Outcome
Grant Support
ID/Acronym/Agency:
DK 070243-04/DK/NIDDK NIH HHS; DK067981-05/DK/NIDDK NIH HHS; K08 DK067981-05/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Angiotensin Receptor Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Biological Markers; 0/Serum Albumin; 60-27-5/Creatinine
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