Lower Albumin Predicts Worse Post-Transplant Outcomes

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Lower pretransplant serum albumin levels are associated with worse outcomes following renal transplantation, according to researchers.

In a study of 8,961 hemodialysis patients who had their first kidney transplant, researchers found that each 0.2 g/dL increment in pretransplant serum albumin was associated with 13% lower risk of all-cause mortality, 17% reduced risk of cardiovascular mortality, 4% decreased risk of delayed graft function, and 7% reduced risk of death or graft failure combined. Subjects were followed for up to six years after transplantation.

The investigators, led by Kamyar Kalantar-Zadeh, MD, PhD, of the David Geffen School of Medicine at the University of California in Los Angeles (UCLA) and the Harbor-UCLA Medical Center in Torrance, Calif., reported their findings in the American Journal of Transplantation (2011;11:1-10).

“Assuming that a lower pretransplant serum albumin level in hemodialysis patients is a surrogate marker of PEW [protein-energy wasting] or worse sickness, our findings may have major clinical and public health implications in providing care to transplant waitlisted hemodialysis patients,” the authors wrote. “If our findings are verified in additional studies, assessment of nutritional status and comorbid conditions in waitlisted dialysis patients may become an important task in care to transplant waitlisted patients.”

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