Kidney Week

Abstract: SA-PO172

Serum Albumin Concentration, Estimated Glomerular Filtration Rate, and Cardiovascular Mortality among 1999-2010 NHANES Participants

Session Information

• Nutrition, Inflammation, Metabolism: Clinical Trials, Biomarkers, Epidemiology
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Nutrition, Inflammation, and Metabolism

• 1401 Nutrition, Inflammation, Metabolism

Authors

• Tortorici, Amanda R., UC Irvine, Orange, California, United States

Amanda R. Tortorici,

• Streja, Elani, UC Irvine, Orange, California, United States

Elani Streja,

• Soohoo, Melissa, UC Irvine, Orange, California, United States

Melissa Soohoo,

• Gillen, Daniel L., UC Irvine, Orange, California, United States

Daniel L. Gillen,

• Rhee, Connie, UC Irvine, Orange, California, United States

Connie Rhee,

• Norris, Keith C., UCLA, Los Angeles, California, United States

Keith C. Norris,

• Kalantar-Zadeh, Kamyar, UC Irvine, Orange, California, United States

Kamyar Kalantar-Zadeh,

Background

As a potential strong predictor of longevity in persons with chronic kidney disease, we sought to examine whether higher serum albumin (Alb) levels are associated with reduced cardiovascular mortality in a nationally representative cohort of NHANES participants.

Methods

We identified 31,274 participants from the 1999-2010 continuous NHANES survey who had available Alb measurements and laboratory values for calculation of eGFR, as well as cardiovascular mortality data. Follow up time began the day after Alb measurement until December 31, 2011. We analyzed the association of Alb (<4.2, 4.2-<4.4 and ≥4.4 g/dL) with cardiovascular mortality across strata of eGFR (<60, 60-<90, and ≥90 ml/min/1.73m²) using Cox proportional hazards models adjusted for age, sex, race, smoking, diabetes and education.

Results

The mean±SD age of the cohort was 48±20 years, among whom 52% were female, 20% were African-American, 22% were Mexican-American, and 7% were other Hispanic American. Across all eGFR strata, participants with Alb levels <4.2 g/dL (n=11,384 people) trended towards higher cardiovascular mortality risks compared to the reference group (Alb 4.2-<4.4 g/dL, n=10,793 people). When stratified by eGFR, participants with Alb levels >4.4 g/dL (n=9,097 overall) trended toward better cardiovascular survival among those with eGFR >60 ml/min/1.73m² (n=8,779), but worse cardiovascular mortality among those with eGFR <60 ml/min/1.73m² (n=318). [Figure]

Conclusion

Among 1999-2010 continuous NHANES participants, lower Alb levels trended toward 30% to 50% higher cardiovascular mortality risk irrespective of the eGFR level. Mortality predictability of Alb and the implications of its screening across the population at large warrants comparison to a lipid panel screening.

Figure

Funding

• NIDDK Support