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Published on: July 19, 2018
C-reactive protein to albumin ratio predicts future volume overload in peritoneal dialysis patients: a retrospective
Tianlei Chen1, Feixia Liu1, Yun Zou1
1Department of Nephrology, Changzhou First People's Hospital, Changzhou, PR China.
Aims:
To evaluate the predictive value of the C-reactive protein to albumin ratio (CAR) for 6-month volume overload in peritoneal dialysis (PD) patients.
Methods:
Retrospective cohort study of 167 stable PD patients without baseline volume overload. CAR was measured at enrollment; volume status was reassessed via bioelectrical impedance analysis (BIA) at 6 months. Multivariate logistic regression, ROC, and restricted cubic spline (RCS) analyses were used.
Results:
During follow-up, 64 patients (38.3%) developed volume overload. These patients had significantly higher baseline CAR levels (p < 0.001). Multivariate analysis identified diabetes (OR = 11.85) and baseline CAR (OR = 9.72) as independent predictors. The AUC for CAR predicting volume overload was 0.73, which is superior to that of CRP or albumin alone. An optimal CAR cutoff of 1.09 yielded 73.2% sensitivity and 60.7% specificity. RCS analysis indicated a linear dose-response relationship between CAR and volume overload risk (P for non-linearity = 0.501).
Conclusion:
Baseline CAR is a simple, low-cost biomarker for predicting 6-month volume overload in PD patients, valuable for risk stratification in resource-limited settings.
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