title: Hypoalbuminemia seems to be associated with a higher rate of hospitalization in hemodialysis patients.
abstract: BACKGROUND
  Anemia, inflammation and hypoalbuminemia are frequent disorders among patients underwent hemodialysis. There are few national data, particularly from Northeast region where anemia and malnourished were common findings, analyzing the association between these conditions and clinical outcomes.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the impact of the presence of anemia, inflammation and hypoalbuminemia on clinical outcomes (death and hospitalization) of hemodialysis patients.
  
  
  METHODS
  In this prospective observational study 221 adult patients were evaluated, considering the presence of anemia (hemoglobin ≤ 10 g/dL), inflammation (C-reactive protein (CRP) ≥ 0,5 mg/dL) and hypoalbuminemia (albumin < 3,8 g/ dL) at baseline. Clinical outcomes were recorded over 13 months.
  
  
  RESULTS
  The occurrence of hospitalization and death did not differ between the groups with and without anemia or inflammation. Patients with hypoalbuminemia had more hospitalizations, and the presence of hypoalbuminemia was associated with shorter hospitalization event-free time (p = 0.008). There was a trend of shorter hospitalization event-free time among patients with increased PCR (p = 0.08). There was no correlation between albumin and CRP levels. The presence of anemia, inflammation and hypoalbuminemia were not associated with lower survival. Adjusting for confounders, hypoalbuminemia was a predictor of hospitalization in hemodialyzed patients.
  
  
  CONCLUSIONS
  The presence of hypoalbuminemia, but not anemia or inflammation, was able to predict hospitalization in hemodialysis patients.
authors.affiliation: Universidade Federal de Alagoas, Brazil.
authors.forename: Sandra Azevedo
authors.initials: SA
authors.lastname: Antunes
authors.affiliation: Universidade Federal de São Paulo, Brazil.
authors.forename: Maria Eugenia F
authors.initials: ME
authors.lastname: Canziani
authors.affiliation: Hospital Sanatório, Brazil.
authors.forename: Arnon Farias
authors.initials: AF
authors.lastname: Campos
authors.affiliation: Universidade Federal de Alagoas, Brazil.
authors.forename: Rosana Quintela Brandão
authors.initials: RQ
authors.lastname: Vilela
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D034141:Hypoalbuminemia / Q000453:epidemiology*; D007249:Inflammation / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis
chemical_list: D006454:Hemoglobins; D012709:Serum Albumin; D002097:C-Reactive Protein