Association between hypoalbuminemia and mortality in patients undergoing continuous renal replacement therapy: A systematic review and meta-analysis

The review aimed to assess if hypoalbuminemia can predict mortality in patients undergoing continuous renal replacement therapy (CRRT). PubMed, Web of Science, Embase, and CENTRAL were searched for relevant articles published up to 24 July 2022. Adjusted data were pooled to calculate the odds ratio (OR). Sensitivity and meta-regression analysis was conducted. Five studies with 5254 patients were included. Meta-analysis of all five studies demonstrated that hypoalbuminemia was a significant predictor of mortality after CRRT (OR: 1.31 95% CI: 1.07, 1.60 I(2) = 72% p = 0.01). The results did not change on sensitivity analysis. On meta-regression, we noted that variables like age, male gender, BMI, percentage of diabetics, and pre-CRRT SOFA score had no statistically significant influence on the outcome. Data from a limited number of studies suggest that hypoalbuminemia before initiation of CRRT is an independent predictor of early mortality. Based on current evidence, it may be suggested that patients with low albumin levels initiating CRRT should be prioritized and treated aggressively to reduce adverse outcomes.