Abstract P313: Critical Cut-off Points of Serum Albumin Level that Indicate Abrupt Increase in Mortality Risk are Different Between Causes of Death Among Hemodialysis Patients
Background: Hypoalbuminemia is a strong risk factor of all-cause death in dialysis patients. However, which cause of death is mainly attributed to hypoalbuminemia in dialysis patients and whether cut-off point of serum albumin (ALB) that indicates abrupt risk elevation in mortality exists have not been elucidated in prospective studies.
Methods: A population-based prospective study of adult hemodialysis patients was carried out. A total of 1213 male and female hemodialysis patients were enrolled and divided into six groups according to ALB levels (G1: ALB < 3.4; G2: 3.4 ≤ ALB ≤ 3.5; G3: 3.6 ≤ ALB ≤ 3.7; G4: 3.8 ≤ ALB ≤ 3.9; G5: 4.0 ≤ ALB ≤ 4.1; ALB ≥ 4.2 g/dl). Main outcomes were all-cause death (ACD), cardiovascular death (CVD), infectious disease-related death (IFD), malignant disease-related death (MAD), incident acute myocardial infarction (AMI) and stroke. Sex- and age-adjusted mortality and incidence rates were estimated in the groups using Poisson’s regression analysis.
Results: A total of 457 patients died during the 5 year observation period (4,788 person-years). Risks for ACD, IFD and incident AMI became exponentially elevated at 3.5 g/dl or lower of ALB and risks for CVD, MAD and incident stroke increased less than 3.4 g/dl of ALB (see table).
Conclusion: Although severely reduced ALB was strongly associated with elevated risks of all-cause and cause-specific death, critical cut off points of ALB that indicate abrupt increase in mortality and morbidity risks were different in ACD, CVD, MAD, AMI and stroke among hemodialysis patients.
- © 2013 by American Heart Association, Inc.