title: Prognostic Significance of 1-Year Serum Albumin Levels Within the Normal Range After Kidney Transplantation.
abstract: Hypoalbuminemia is associated with poor outcomes in kidney transplantation (KT). However, what level is optimal in serum albumin is not clear for the long-term prognosis. To determine whether the long-term outcomes are different even between the normal ranges of serum albumin after KT, we analyzed data from 404 renal allograft recipients whose 1-year post-transplant serum albumin levels were within the normal limits (3.5-5.5 g/dL). During a follow-up of 122 ± 56 months, 97 graft losses, 20 patient deaths, and 50 cardiovascular (CV) events occurred. Based on 1-year serum albumin levels, the patients were divided into high normal (≥4.6 g/dL, n = 209) and low normal (<4.6 g/dL, n = 195) groups. Kaplan-Meier analyses revealed that the low normal group had poorer allograft survival (P = 0.01), patient survival (P < 0.001), and CV event-free survival (P < 0.001) than the high normal group. Cox regression analysis confirmed that 1-year serum albumin was inversely associated with the risk of graft loss (hazard ratio [HR] 0.414, 95% confidence interval [CI] 0.200-0.856), patient death (HR 0.097, 95% CI 0.019-0.484), and CV events (HR 0.228, 95% CI 0.074-0.702). In conclusion, a relatively low 1-year post-transplant serum albumin level within the normal limits (<4.6 g/dL) significantly predicts poor long-term outcomes.
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Il Hwan
authors.initials: IH
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Joon-Sung
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Chang Hwa
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Chong Myung
authors.initials: CM
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Gheun-Ho
authors.initials: GH
authors.lastname: Kim
mesh_terms: D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis* / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D012016:Reference Values; D012709:Serum Albumin / Q000032:analysis*; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D012709:Serum Albumin
keywords: Albumin; Allograft survival; Cardiovascular mortality; Kidney transplantation; Patient survival