Association Between Serum Prealbumin Level and Outcomes in Prevalent Kidney Transplant Recipients

Abduzhappar Gaipov, Christopher D. Jackson, Manish Talwar, Vasanthi Balaraman, Arijit Chakravarty, Orsolya Cseprekal, Zoltan Mathe, Adam Remport, Csaba P. Kovesdy, James D. Eason, Istvan Mucsi, Miklos Z. Molnar

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective(s): Prealbumin, a transport protein mostly synthesized in the liver, is a marker of nutrition. Although 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. Design: This was a prospective prevalent cohort study. This 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 estimated glomerular filtration rate (R = −0.28; P <.001) and high-sensitive C-reactive protein (R = −0.24; P <.001). Each 5 mg/dL lower serum prealbumin level was associated with 20% higher risk of death with functioning graft (subdistribution hazard ratio [95% confidence interval]: 1.20 [1.08-1.35]; P =.001), which persisted after multivariable adjustments (subdistribution hazard ratio [95% confidence interval]: 1.13 [1.00-1.28]; P =.039). Qualitatively similar trend was observed in all-cause mortality; however, there was no association between prealbumin levels and graft loss. Conclusion(s): Lower serum prealbumin level is associated with increased risk of death with functioning graft in prevalent kidney transplant recipients.

Original languageEnglish
JournalJournal of Renal Nutrition
DOIs
Publication statusPublished - Jan 1 2019

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Prealbumin
Kidney
Serum
Transplants
Mortality
Confidence Intervals
Transplant Recipients
Glomerular Filtration Rate
C-Reactive Protein
Chronic Kidney Failure
Carrier Proteins
Cohort Studies
Survival
Liver

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Nephrology

Cite this

Association Between Serum Prealbumin Level and Outcomes in Prevalent Kidney Transplant Recipients. / Gaipov, Abduzhappar; Jackson, Christopher D.; Talwar, Manish; Balaraman, Vasanthi; Chakravarty, Arijit; Cseprekal, Orsolya; Mathe, Zoltan; Remport, Adam; Kovesdy, Csaba P.; Eason, James D.; Mucsi, Istvan; Molnar, Miklos Z.

In: Journal of Renal Nutrition, 01.01.2019.

Research output: Contribution to journalArticle

Gaipov, A, Jackson, CD, Talwar, M, Balaraman, V, Chakravarty, A, Cseprekal, O, Mathe, Z, Remport, A, Kovesdy, CP, Eason, JD, Mucsi, I & Molnar, MZ 2019, 'Association Between Serum Prealbumin Level and Outcomes in Prevalent Kidney Transplant Recipients', Journal of Renal Nutrition. https://doi.org/10.1053/j.jrn.2019.01.003
Gaipov, Abduzhappar ; Jackson, Christopher D. ; Talwar, Manish ; Balaraman, Vasanthi ; Chakravarty, Arijit ; Cseprekal, Orsolya ; Mathe, Zoltan ; Remport, Adam ; Kovesdy, Csaba P. ; Eason, James D. ; Mucsi, Istvan ; Molnar, Miklos Z. / Association Between Serum Prealbumin Level and Outcomes in Prevalent Kidney Transplant Recipients. In: Journal of Renal Nutrition. 2019.
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AU - Gaipov, Abduzhappar

AU - Jackson, Christopher D.

AU - Talwar, Manish

AU - Balaraman, Vasanthi

AU - Chakravarty, Arijit

AU - Cseprekal, Orsolya

AU - Mathe, Zoltan

AU - Remport, Adam

AU - Kovesdy, Csaba P.

AU - Eason, James D.

AU - Mucsi, Istvan

AU - Molnar, Miklos Z.

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N2 - Objective(s): Prealbumin, a transport protein mostly synthesized in the liver, is a marker of nutrition. Although 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. Design: This was a prospective prevalent cohort study. This 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 estimated glomerular filtration rate (R = −0.28; P <.001) and high-sensitive C-reactive protein (R = −0.24; P <.001). Each 5 mg/dL lower serum prealbumin level was associated with 20% higher risk of death with functioning graft (subdistribution hazard ratio [95% confidence interval]: 1.20 [1.08-1.35]; P =.001), which persisted after multivariable adjustments (subdistribution hazard ratio [95% confidence interval]: 1.13 [1.00-1.28]; P =.039). Qualitatively similar trend was observed in all-cause mortality; however, there was no association between prealbumin levels and graft loss. Conclusion(s): Lower serum prealbumin level is associated with increased risk of death with functioning graft in prevalent kidney transplant recipients.

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