Abstract: SA-PO1196
Association of High Albumin-Corrected Anion Gap with Mortality in Patients with CKD: Retrospective Analysis of the MIMIC-IV Database
Session Information
- CKD: Biomarkers and Emerging Tools for Diagnosis and Monitoring
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Li, Piao, Changsha Central Hospital, Changsha, Hunan, China
- Xie, Rou, Changsha Central Hospital, Changsha, Hunan, China
- Wen, Rui, Changsha Central Hospital, Changsha, Hunan, China
- Qin, Jiao, Changsha Central Hospital, Changsha, Hunan, China
Background
In patients with advanced chronic kidney disease (CKD), disturbances in acid-base balance are common. The anion gap (AG) is a metric used to assess acid-base status, but various factors can influence it. The albumin-corrected anion gap (ACAG) adjusts AG for the effect of albumin levels. This study investigated the relationship between ACAG and all-cause mortality (ACM) in CKD patients treated in the intensive care unit (ICU).
Methods
We extracted CKD patients from the MIMIC-IV database. Patients were then stratified into groups (quartiles) based on their ACAG levels. Mortality was assessed at various time points: in-hospital, 30 days, 90 days, and 365 days after ICU admission. Cox proportional hazards regression and restricted cubic splines (RCS) were used to analyze the relationship between ACAG and ACM. Additionally, Kaplan-Meier curves were estimated to depict survival probability.
Results
The study included 1,370 patients, with 62.5% being male. Mortality rates were concerning, with 35.5% dying in the hospital, 44.7% within 30 days, 59.8% within 90 days, and 78.9% within 365 days of ICU admission. The adjusted hazard ratios (HRs) were 2.95, 2.67, 2.28, and 1.96 at each respective time point, with all p values less than 0.001. RCS analysis revealed a linear increase in mortality risk with rising ACAG levels, particularly when exceeding 19 mmol/L. Increased ACAG levels were associated with ACM across all subgroups.
Conclusion
Our findings demonstrate a significant correlation between elevated ACAG and ACM in CKD patients admitted to the ICU.