ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO1160

Serum Albumin and Hospitalization Among Pediatric Patients Who Started Dialysis Therapy

Session Information

  • Pediatric Nephrology - I
    October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1600 Pediatric Nephrology

Authors

  • Okuda, Yusuke, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
  • Obi, Yoshitsugu, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
  • Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
  • Laster, Marciana, University of California Los Angeles, Los Angeles, California, United States
  • Rhee, Connie, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
  • Langman, Craig B., Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
  • Jernigan, Stephanie M., Emory University School of Medicine, Atlanta, Georgia, United States
  • Salusky, Isidro B., University of California Los Angeles, Los Angeles, California, United States
  • Tentori, Francesca, DaVita Clinical Research, Denver, Colorado, United States
  • Schreiber, Martin J., DaVita Clinical Research, Denver, Colorado, United States
  • Brunelli, Steven M., DaVita Clinical Research, Denver, Colorado, United States
  • Kalantar-Zadeh, Kamyar, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
Background

Hypoalbuminemia is a strong predictor of hospitalization in adult dialysis patients. However, there are scarce data on the association between serum albumin levels and hospitalization among pediatric patients new to dialysis therapy.

Methods

In a cohort of children (1–17 years) who received dialysis therapy at a large US dialysis organization during 2007–2011 and who had available data on serum albumin within 1 year following initiation of dialysis, we examined the association of serum albumin levels with hospitalization frequency and total hospitalization days using negative binomial regression models. Hospitalizations for transplantation were excluded.

Results

Among eligible patients, median (IQR) age was 14 (10–16) years and mean±SD baseline serum albumin level was 3.7±0.8 g/dL. There appeared to be a U-shaped association between serum albumin and hospitalization frequency; hospitalization rates (95% CI) were 2.7 (2.2–3.2), 1.9 (1.5–2.4), 1.6 (1.3–1.9), 2.7 (1.7–3.6) per patient-year among patients with serum albumin levels <3.5, 3.5 to <4.0, 4.0 to <4.5 and ≥4.5 g/dL, respectively. The case mix-adjusted incidence rate ratios (IRRs) (95% CI) were 1.63 (1.24–2.13), 1.32 (1.10–1.58), and 1.25 (1.06–1.49) at serum albumin level of 3.0, 3.5, and 4.5 g/dL, respectively (ref: 4.0 g/dL). Consistent trends were observed in hospitalization days [Figure].

Conclusion

Both high and low serum albumin levels were associated with hospitalization in children with ESRD on dialysis. Hospitalization for high serum albumin may be due to favorable or unfavorable status, such as access placement or dehydration, respectively.

Funding

  • NIDDK Support