Expert opinion of nephrologists about the effectiveness of low-protein diet in different stages of chronic kidney disease (CKD)

Effect of serum albumin on the prognosis of elderly patients with stage 3-4 chronic kidney disease

OBJECTIVE

To investigate the influence of serum albumin on the prognosis of elderly patients with stage 3-4 chronic kidney disease (CKD).

METHODS

From July 2013 to November 2015, elderly CKD patients (≥60 years), with eGFR ≥15 mL/min/1.73 m² and <60 mL/min/1.73 m², with CKD stage 3-4 in the geriatric nephrology clinic were enrolled. General information and underlying diseases were recorded. Laboratory indices were evaluated. Composite endpoint events (CEE) including renal endpoint events, cardiocerebral vascular endpoint events, and death were elucidated. Based on the ROC curves, the patients were divided into lower and higher serum albumin groups (<42.5 and ≥42.5 g/L).

RESULTS

The occurrence of CEEs was significantly higher in lower serum albumin group than those in the higher group. Also, the patients in the higher group were significantly younger with lower urinary protein, blood urea, brain natriuretic peptide, and cystatin C than those in the lower serum albumin group. Contrastingly, hemoglobin, total serum protein, serum calcium, and superoxide dismutase were remarkably higher. The composite endpoints of multifactor logistic regression analysis indicated that as the serum albumin is increased by every 1 g/L, the probability of CEEs would reduce 14.8%, and the risk occurrence rate of the lower serum albumin group was 4.739 fold than the higher group.

CONCLUSION

The results suggest that patients with higher serum albumin had a better prognosis than those with lower serum albumin. The low level was an independent risk factor influencing the prognosis of elderly patients in stage 3-4 CKD.