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 journalArticlepeer-review

3 Citations (Scopus)


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
Pages (from-to)188-195
Number of pages8
JournalJournal of Renal Nutrition
Issue number3
Publication statusPublished - May 2019

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