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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 patients...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society for Transplantation
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10090834/ https://www.ncbi.nlm.nih.gov/pubmed/37064772 http://dx.doi.org/10.4285/kjt.22.0047 |
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author | Kwon, Jae Wan Jeon, Yena Jung, Hee-Yeon Choi, Ji-Young Park, Sun-Hee Kim, Chan-Duck Kim, Yong-Lim Hwang, Deokbi Yun, Woo-Sung Kim, Hyung-Kee Huh, Seung Yoo, Eun Sang Won, Dong-Il Cho, Jang-Hee Lim, Jeong-Hoon |
author_facet | Kwon, Jae Wan Jeon, Yena Jung, Hee-Yeon Choi, Ji-Young Park, Sun-Hee Kim, Chan-Duck Kim, Yong-Lim Hwang, Deokbi Yun, Woo-Sung Kim, Hyung-Kee Huh, Seung Yoo, Eun Sang Won, Dong-Il Cho, Jang-Hee Lim, Jeong-Hoon |
author_sort | Kwon, Jae Wan |
collection | PubMed |
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 first 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. |
format | Online Article Text |
id | pubmed-10090834 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Korean Society for Transplantation |
record_format | MEDLINE/PubMed |
spelling | pubmed-100908342023-04-13 Pretransplant C-reactive protein-to-albumin ratio predicts mortality in kidney transplant recipients: a retrospective cohort study Kwon, Jae Wan Jeon, Yena Jung, Hee-Yeon Choi, Ji-Young Park, Sun-Hee Kim, Chan-Duck Kim, Yong-Lim Hwang, Deokbi Yun, Woo-Sung Kim, Hyung-Kee Huh, Seung Yoo, Eun Sang Won, Dong-Il Cho, Jang-Hee Lim, Jeong-Hoon Korean J Transplant Original Article 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 first 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. The Korean Society for Transplantation 2023-03-31 2023-02-23 /pmc/articles/PMC10090834/ /pubmed/37064772 http://dx.doi.org/10.4285/kjt.22.0047 Text en Copyright © 2023 The Korean Society for Transplantation https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kwon, Jae Wan Jeon, Yena Jung, Hee-Yeon Choi, Ji-Young Park, Sun-Hee Kim, Chan-Duck Kim, Yong-Lim Hwang, Deokbi Yun, Woo-Sung Kim, Hyung-Kee Huh, Seung Yoo, Eun Sang Won, Dong-Il Cho, Jang-Hee Lim, Jeong-Hoon Pretransplant C-reactive protein-to-albumin ratio predicts mortality in kidney transplant recipients: a retrospective cohort study |
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 | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10090834/ https://www.ncbi.nlm.nih.gov/pubmed/37064772 http://dx.doi.org/10.4285/kjt.22.0047 |
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