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Kidney Week

Abstract: TH-PO136

Association Between Serum Pre-Albumin Level and Outcomes in Prevalent Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Gaipov, Abduzhappar, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Jackson, Christopher D., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Talwar, Manish, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Balaraman, Vasanthi, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Chakravarty, Arijit, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Cseprekál, Orsolya, Semmelweis University, Budapest, Hungary
  • Mathe, Zoltan, Semmelweis University, Budapest, Hungary
  • Remport, Adam, Semmelweis University, Budapest, Hungary
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Eason, James D., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Mucsi, Istvan, University of Toronto, Toronto, Ontario, Canada
Background

Prealbumin, a transport protein mostly synthesized in the liver, is a marker of nutrition. While decreased prealbumin levels are associated with increased mortality in end stage kidney disease patients, its association with mortality in kidney transplant recipients remains unknown. We evaluated the association between prealbumin levels and outcomes in kidney transplant recipients.

Methods

This prospective cohort study included 991 kidney transplant recipients enrolled from December 31, 2006 to December 31, 2007 and followed over a 6-year period. Sociodemographic, past medical history, clinical and laboratory data were collected at the study entry. Associations between prealbumin levels and death with functioning graft, all-cause mortality and graft loss were examined using survival models.

Results

Serum prealbumin levels showed significant negative correlation with eGFR (R=-0.28, p<0.001), and hsCRP (R=-0.24, p<0.001) (Figure 1). Each 5 mg/dL lower serum prealbumin level was associated with 20% higher risk of death with functioning graft (Hazard Ratio (HR) [95% Confidence Interval (CI)]: 1.20 [1.08–1.35], p=0.001), which persisted after multivariable adjustments (HR [95%CI]: 1.13 [1.00–1.28], p=0.039) (Figure 2). Qualitatively similar trend was observed in all-cause mortality; however, there was no association between prealbumin levels and graft loss (Figure 2).

Conclusion

Lower serum prealbumin level is associated with increased risk of death with functioning graft and all-cause mortality in prevalent kidney transplant recipients.

Figure 1: Association between serum prealbumin level with eGFR (panel A) and serum C-reactive protein (panel B).

Figure 2: An adjusted association of serum prealbumin levels with death with functioning graft (panel A), all-cause mortality (panel B) and death censored graft loss (panel C) using cubic splines