Trends and outcomes associated with serum albumin concentration among incident dialysis patients in the United States.
OBJECTIVE
Serum albumin concentrations are associated with mortality, and respond to nutritional and inflammatory states. To explore whether changing demographics and practice patterns in dialysis have influenced serum albumin concentrations, we analyzed trends in serum albumin among incident patients on dialysis from 1995 through 2004.


RESULTS
Mean serum albumin concentrations declined significantly over time, even after accounting for changes in age, diabetes, body size, and other factors. Although laboratory assays were not uniform within or across years, serum albumin declined over time, regardless of the reported laboratory lower limit of normal. Moreover, serum albumin retained its potent association with mortality over time. Lower serum albumin was especially hazardous among younger patients and blacks, and was less hazardous among persons with diabetes as a primary cause of kidney disease.


CONCLUSIONS
Despite higher body weights and the initiation of dialysis earlier in the course of progressive chronic kidney disease, hypoalbuminemia remains common and hazardous to persons starting dialysis.
Kaysen
George A
GA
Division of Nephrology, Department of Medicine and Department of Biochemistry and Molecular Medicine, University of California at Davis, Davis, California, USA.
Johansen
Kirsten L
KL
Cheng
Su-Chun
SC
Jin
Chengshi
C
Chertow
Glenn M
GM
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight / Q000502:physiology; D003920:Diabetes Mellitus / Q000097:blood*; D003956:Dialysis; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000401:mortality*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D015999:Multivariate Analysis; D009752:Nutritional Status; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D016896:Treatment Outcome; D014481:United States
D012709:Serum Albumin