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

Yusuke Okuda,

• Obi, Yoshitsugu, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States

Yoshitsugu Obi,

• Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States

Elani Streja,

• Laster, Marciana, University of California Los Angeles, Los Angeles, California, United States

Marciana Laster,

• Rhee, Connie, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States

Connie Rhee,

• Langman, Craig B., Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States

Craig B. Langman,

• Jernigan, Stephanie M., Emory University School of Medicine, Atlanta, Georgia, United States

Stephanie M. Jernigan,

• Salusky, Isidro B., University of California Los Angeles, Los Angeles, California, United States

Isidro B. Salusky,

• Tentori, Francesca, DaVita Clinical Research, Denver, Colorado, United States

Francesca Tentori,

• Schreiber, Martin J., DaVita Clinical Research, Denver, Colorado, United States

Martin J. Schreiber,

• Brunelli, Steven M., DaVita Clinical Research, Denver, Colorado, United States

Steven M. Brunelli,

• 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

Kamyar Kalantar-Zadeh,

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