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Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients

Background: Nutrition and inflammation have been implicated in predicting mortality in patients on peritoneal dialysis (PD). Serum albumin and globulin can be regarded for the nutritional and inflammatory status. However, there is lack of data to evaluate the synergistic effect of albumin and globul...

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Autores principales: Lai, Kuan-Ju, Hsieh, Yao-Peng, Chiu, Ping-Fang, Lin, Pei-Ru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324370/
https://www.ncbi.nlm.nih.gov/pubmed/35889807
http://dx.doi.org/10.3390/nu14142850
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author Lai, Kuan-Ju
Hsieh, Yao-Peng
Chiu, Ping-Fang
Lin, Pei-Ru
author_facet Lai, Kuan-Ju
Hsieh, Yao-Peng
Chiu, Ping-Fang
Lin, Pei-Ru
author_sort Lai, Kuan-Ju
collection PubMed
description Background: Nutrition and inflammation have been implicated in predicting mortality in patients on peritoneal dialysis (PD). Serum albumin and globulin can be regarded for the nutritional and inflammatory status. However, there is lack of data to evaluate the synergistic effect of albumin and globulin on mortality prediction. Methods: In 554 patients initiating PD from January 2001 to July 2016, we divided them into four groups by the combination of two categories of low vs. high albumin and low vs. high globulin. The median values for albumin and globulin were chosen to classify them into low or high groups. Their associations with all-cause and cardiovascular (CV) mortality were examined in Cox regression models adjusted for confounding clinical and laboratory data. Results: Patients, 52.91 ± 15.2 years old and 47.8% men, had a median (interquartile range) value of 3.3 (2.9–3.8) g/dL for albumin and 2.8 (2.5–3.2) g/dL for globulin, respectively. Patients with low albumin and high globulin had the highest all-cause mortality and CV mortality, with adjusted hazard ratios of 3.87 (95% CI 1.83–8.20, p < 0.001) and 5.65 (95% CI 2.23–14.34, p < 0.001), respectively, compared with those with a high albumin and low globulin having the lowest mortality rate. Sensitivity analyses further confirmed this relationship. Conclusions: A patient profile of either low albumin or high globulin is linked to a higher risk for mortality, particularly for a profile of both low albumin and high globulin compared with one without either of them. Further studies are needed to explore the mechanisms underlying this phenomenon and how to improve clinical outcomes in those high-risk patients.
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spelling pubmed-93243702022-07-27 Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients Lai, Kuan-Ju Hsieh, Yao-Peng Chiu, Ping-Fang Lin, Pei-Ru Nutrients Article Background: Nutrition and inflammation have been implicated in predicting mortality in patients on peritoneal dialysis (PD). Serum albumin and globulin can be regarded for the nutritional and inflammatory status. However, there is lack of data to evaluate the synergistic effect of albumin and globulin on mortality prediction. Methods: In 554 patients initiating PD from January 2001 to July 2016, we divided them into four groups by the combination of two categories of low vs. high albumin and low vs. high globulin. The median values for albumin and globulin were chosen to classify them into low or high groups. Their associations with all-cause and cardiovascular (CV) mortality were examined in Cox regression models adjusted for confounding clinical and laboratory data. Results: Patients, 52.91 ± 15.2 years old and 47.8% men, had a median (interquartile range) value of 3.3 (2.9–3.8) g/dL for albumin and 2.8 (2.5–3.2) g/dL for globulin, respectively. Patients with low albumin and high globulin had the highest all-cause mortality and CV mortality, with adjusted hazard ratios of 3.87 (95% CI 1.83–8.20, p < 0.001) and 5.65 (95% CI 2.23–14.34, p < 0.001), respectively, compared with those with a high albumin and low globulin having the lowest mortality rate. Sensitivity analyses further confirmed this relationship. Conclusions: A patient profile of either low albumin or high globulin is linked to a higher risk for mortality, particularly for a profile of both low albumin and high globulin compared with one without either of them. Further studies are needed to explore the mechanisms underlying this phenomenon and how to improve clinical outcomes in those high-risk patients. MDPI 2022-07-12 /pmc/articles/PMC9324370/ /pubmed/35889807 http://dx.doi.org/10.3390/nu14142850 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lai, Kuan-Ju
Hsieh, Yao-Peng
Chiu, Ping-Fang
Lin, Pei-Ru
Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients
title Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients
title_full Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients
title_fullStr Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients
title_full_unstemmed Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients
title_short Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients
title_sort association of albumin and globulin with mortality risk in incident peritoneal dialysis patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9324370/
https://www.ncbi.nlm.nih.gov/pubmed/35889807
http://dx.doi.org/10.3390/nu14142850
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