title: The effect of serum albumin at the start of continuous ambulatory peritoneal dialysis treatment on patient survival.
abstract: OBJECTIVE
  To analyze the effect of serum albumin using immunoturbidimetry, demographic, biochemical, and kinetic factors on survival of continuous ambulatory peritoneal dialysis (CAPD) patients.
  
  
  METHODS
  A review of prospectively collected data in a 2-year follow-up study of peritoneal transport kinetics.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  Sixty-one patients, evaluated within 3 months after the start of CAPD.
  
  
  METHODS
  Covariables used in the survival analysis were plasma urea, and creatinine, albumin, hemoglobin, mass transfer area coefficient of creatinine, peritoneal albumin clearance, 4-hour peritoneal albumin loss, net ultrafiltration, age, blood pressure, body mass index, difference between actual and ideal bodyweight, and presence or absence of systemic disease.
  
  
  RESULTS
  Overall survival was 64% at 2 years. Median serum albumin was 30.9 g/L, range 18.1-43.9 g/L. Patients with a serum albumin below the median had a lower survival rate than those higher than the median (2-year survival 49% vs 79%, p = 0.01). Using the Cox model, survival was related to systemic disease (p = 0.004), age (p = 0.02), hemoglobin (p = 0.03), and serum albumin (p = 0.1).
  
  
  CONCLUSIONS
  The results confirm the strength of serum albumin as predictor of survival. However, in this study serum albumin merely reflected the presence of a systemic disease, which was the most important risk factor for patient survival.
authors.affiliation: Department of Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: D G
authors.initials: DG
authors.lastname: Struijk
authors.forename: R T
authors.initials: RT
authors.lastname: Krediet
authors.forename: G C
authors.initials: GC
authors.lastname: Koomen
authors.forename: E W
authors.initials: EW
authors.lastname: Boeschoten
authors.forename: L
authors.initials: L
authors.lastname: Arisz
mesh_terms: D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000401:mortality*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D012709:Serum Albumin