Serum albumin concentration and risk of end-stage renal disease: the REGARDS study.

ABSTRACT: Background:Serum albumin concentration is a commonly available biomarker with prognostic value in many disease states. It is uncertain whether serum albumin concentrations are associated with incident end-stage renal disease (ESRD) independently of urine albumin-to-creatinine ratio (ACR). Methods:A longitudinal evaluation was performed of a population-based community-living cohort from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Participants were??45?years of age at study entry and had serum albumin, creatinine, cystatin C and spot urine ACR measured at the baseline visit (n?=?19 633). Estimated glomerular filtration rate (eGFR) was from the Chronic Kidney Disease Epidemiology Collaboration combined creatinine-cystatin C equation. Baseline serum albumin concentration was the predictor variable, and hazard ratios (HRs) for incident ESRD (from US Renal Data System linkage) were calculated in sequentially adjusted models. Results:Age at study entry was 63.9?±?9.7?years, 62% of the participants were female and 40% were black. Mean eGFR at baseline was 83.3?±?20.8?mL/min/1.73 m2. Over a median 8-year follow-up, 1.2% (n?=?236) developed ESRD. In models adjusted for baseline eGFR, ACR and other ESRD risk factors, the HR for incident ESRD was 1.16 [95% confidence interval (CI) 1.01-1.33] for each standard deviation (0.33?g/dL) lower serum albumin concentration. The HR comparing the lowest (<4?g/dL) and highest quartiles (?4.4?g/dL) of serum albumin was 1.61 (95% CI 0.98-2.63). Results were qualitatively similar among participants with eGFR?<60 and??60?mL/min/1.73 m2, and those with and without diabetes. Conclusions:In community-dwelling US adults, lower serum albumin concentration is associated with higher risk of incident ESRD independently of baseline urine ACR, eGFR and other ESRD risk factors.

SUBMITTER: Walther CP 

PROVIDER: S-EPMC7191876 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature