Related Experiment Videos
Are serum albumin and cholesterol reliable outcome markers in elderly dialysis patients?
G B Piccoli1, F Quarello, M Salomone
1Nephro-Urology Institute of the University, Torino, Italy.
Insights
Albumin and cholesterol levels at dialysis initiation are key predictors of patient survival, even in those without other risk factors. Low albumin significantly impacts survival, highlighting its importance as an outcome marker.
Area of Science:
- Nephrology
- Clinical Biochemistry
- Epidemiology
Background:
- Albumin and cholesterol levels are established outcome markers in dialysis patients.
- Their prognostic value may be influenced by age and comorbidities.
- Identifying reliable early markers is crucial for managing dialysis patient outcomes.
Purpose of the Study:
- To analyze age, high-risk conditions, cholesterol, and albumin as outcome markers at dialysis initiation.
- To assess the influence of these markers on patient prognosis.
- To identify subgroups with poorer prognosis irrespective of traditional risk factors.
Main Methods:
- Retrospective analysis of data from the Piedmont Dialysis and Transplantation Registry.
- Inclusion of 5661 patients on dialysis as of December 31, 1992.
- Assessment of albumin, cholesterol, age, and high-risk conditions at the start of dialysis.
Main Results:
- Normal albumin and cholesterol prevalence increased with age.
- Higher prevalence of normal biochemical markers was observed in high-risk patients within each age group.
- Low albumin levels were associated with significantly impaired survival, particularly in elderly patients (age >= 65).
- Albumin's influence on survival was more pronounced than cholesterol's.
Conclusions:
- Albumin and cholesterol are reliable outcome markers at dialysis initiation, even in elderly patients.
- These biochemical markers identify subgroups with poorer prognosis within high-mortality dialysis cohorts.
- Further research is needed to determine if dialysis therapy can reverse the negative effects of low albumin and cholesterol.
Abstract:
Albumin and cholesterol are considered reliable outcome markers in dialysis patients; their influence, however, may also be related to non-independent factors, such as age and presence of co-morbid conditions. The aim of the study was an analysis of four outcome markers, assessed at start of dialysis: age, high risk conditions, cholesterol and albumin levels. Data were obtained from the Piedmont Dialysis and Transplantation Registry (northern Italy, about 4,400,000 inhabitants, 21 dialysis centres, open acceptance since mid-1970s, 5661 patients on file at 31 December 1992). Prevalence of albumin and cholesterol in the normal range increases with age; in each age group prevalence in the range is higher in patients at high risk. However, influence of these biochemical parameters is evident also in no-risk cohorts, thus identifying a subgroup with poorer prognosis also in the population without any identified classic risk factor. The influence of albumin, more evident in the population studied compared with cholesterol, is reflected by impaired survival of low-albumin patients (age > or = 65 high risk at 1 year: 60.7% vs 76.6%, P = 0.0052; age > or = 65 non-high risk, at 1 year: 76.5% vs 90.7%, P = 0.0001). In conclusion, albumin and cholesterol, assessed at start of dialysis, are reliable outcome markers even in elderly patients, identifying, in this high mortality cohort, a subgroup with poorer prognosis. If and how their effect may be reversed by dialysis therapy remains to be assessed.