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Low albumin levels are independently associated with neonatal acute kidney injury: a report from AWAKEN Study Group.
Nada A
,
Askenazi D
,
Kupferman JC
,
Mhanna M
,
Mahan JD
,
Boohaker L
,
Li L
,
Griffin RL
,
AWAKEN Collaborative
.
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BACKGROUND: Data from adult and pediatric literature have shown an association between albumin levels and AKI. Whether hypoalbuminemia and neonatal AKI are associated has not been studied.
METHODS: We evaluated the association of albumin with early (during the first postnatal week) and late (after the first postnatal week) AKI for 531 neonates from the Assessment of Worldwide AKI Epidemiology in Neonates (AWAKEN) database and for 3 gestational age (GA) subgroups: < 29, 29 to < 36, and ≥ 36 weeks GA.
RESULTS: Low albumin levels were associated with increased odds of neonatal AKI; for every 0.1 g/dL decrease in albumin, the odds of late AKI increased by 12% on continuous analysis. After adjustment for potential confounders, neonates with albumin values in the lowest quartiles (< 2.2 g/dL) had an increased odds of early [Adjusted Odd Ratio (AdjOR) 2.5, 95% CI = 1.1-5.3, p < 0.03] and late AKI [AdjOR 13.4, 95% CI = 3.6-49.9, p < 0.0001] compared to those with albumin in the highest quartile (> 3.1 g/dL). This held true for albumin levels 2.3 to 2.6 g/dL for early [AdjOR 2.5, 95% CI = 1.2-5.5, p < 0.02] and late AKI [AdjOR 6.4, 95% CI = 1.9-21.6, p < 0.01]. Albumin quartiles of (2.7 to 3.0 g/dL) were associated with increased odds of late AKI. Albumin levels of 2.6 g/dL and 2.4 g/dL best predicted early (AUC = 0.59) and late AKI (AUC = 0.64), respectively. Analysis of albumin association with AKI by GA is described.
CONCLUSIONS: Low albumin levels are independently associated with early and late neonatal AKI. Albumin could be a potential modifiable risk factor for neonatal AKI.
Askenazi,
Fluid overload and mortality are associated with acute kidney injury in sick near-term/term neonate.
2013, Pubmed
Askenazi,
Fluid overload and mortality are associated with acute kidney injury in sick near-term/term neonate.
2013,
Pubmed
Atkinson,
Hypoalbuminemia may predispose infants to necrotizing enterocolitis.
1989,
Pubmed
Bolat,
Acute kidney injury in a single neonatal intensive care unit in Turkey.
2013,
Pubmed
Cataldi,
Potential risk factors for the development of acute renal failure in preterm newborn infants: a case-control study.
2005,
Pubmed
Charlton,
Late onset neonatal acute kidney injury: results from the AWAKEN Study.
2019,
Pubmed
Charlton,
Incidence and Risk Factors of Early Onset Neonatal AKI.
2019,
Pubmed
Chawla,
Identifying critically ill patients at high risk for developing acute renal failure: a pilot study.
2005,
Pubmed
Curry,
Lessons from the crystallographic analysis of small molecule binding to human serum albumin.
2009,
Pubmed
Cuzzolin,
Postnatal renal function in preterm newborns: a role of diseases, drugs and therapeutic interventions.
2006,
Pubmed
Dixon,
Activation of mitogenic pathways by albumin in kidney proximal tubule epithelial cells: implications for the pathophysiology of proteinuric states.
1999,
Pubmed
Duan,
[Association of hypoalbuminemia with acute kidney injury in children after cardiac surgery].
2018,
Pubmed
Duan,
[Risk factors and prognosis of acute kidney injury in children with sepsis in pediatric intensive care unit].
2019,
Pubmed
Engelman,
L-arginine reduces endothelial inflammation and myocardial stunning during ischemia/reperfusion.
1995,
Pubmed
Ferah,
Acute Kidney Injury After Pediatric Liver Transplantation.
2019,
Pubmed
Findik,
Preoperative Low Serum Albumin Levels Increase the Requirement of Renal Replacement Therapy after Cardiac Surgery.
2016,
Pubmed
Gamba,
Hypoalbuminemia as a risk factor for amikacin nephrotoxicity.
1990,
Pubmed
Gameiro,
Obesity, acute kidney injury and mortality in patients with sepsis: a cohort analysis.
2018,
Pubmed
Giacobbe,
Hypoalbuminemia as a predictor of acute kidney injury during colistin treatment.
2018,
Pubmed
Go,
Effect of Preoperative Albumin Levels on Outcomes in Patients Undergoing Left Ventricular Device Implantation.
2015,
Pubmed
Greenough,
Randomised controlled trial of albumin infusion in ill preterm infants.
1993,
Pubmed
Hall,
Control of glomerular filtration rate by circulating angiotensin II.
1981,
Pubmed
Iacobelli,
Hypoproteinemia on the first day of life and adverse outcome in very preterm infants admitted to the neonatal intensive care unit.
2012,
Pubmed
Iacobelli,
Total plasma protein in very preterm babies: prognostic value and comparison with illness severity scores.
2013,
Pubmed
Iglesias,
Albumin is a major serum survival factor for renal tubular cells and macrophages through scavenging of ROS.
1999,
Pubmed
Jardine,
Albumin infusion for low serum albumin in preterm newborn infants.
2004,
Pubmed
Jetton,
Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates: Design of a Retrospective Cohort Study.
2016,
Pubmed
Jetton,
Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study.
2017,
Pubmed
Jetton,
Acute kidney injury in the neonate.
2014,
Pubmed
Kaufmann,
Nitric oxide dose-response study in the isolated perfused rat kidney after inhibition of endothelium-derived relaxing factor synthesis: the role of serum albumin.
1995,
Pubmed
Khwaja,
KDIGO clinical practice guidelines for acute kidney injury.
2012,
Pubmed
Kim,
Potentially modifiable risk factors for acute kidney injury after surgery on the thoracic aorta: a propensity score matched case-control study.
2015,
Pubmed
Koralkar,
Acute kidney injury reduces survival in very low birth weight infants.
2011,
Pubmed
Kwon,
Predictors of acute kidney injury associated with intravenous colistin treatment.
2010,
Pubmed
Lang,
Serum albumin and kidney function decline in HIV-infected women.
2014,
Pubmed
Lang,
Association of serum albumin levels with kidney function decline and incident chronic kidney disease in elders.
2018,
Pubmed
Lee,
Preoperative hypoalbuminemia is a major risk factor for acute kidney injury following off-pump coronary artery bypass surgery.
2012,
Pubmed
Lee,
Effect of Exogenous Albumin on the Incidence of Postoperative Acute Kidney Injury in Patients Undergoing Off-pump Coronary Artery Bypass Surgery with a Preoperative Albumin Level of Less Than 4.0 g/dl.
2016,
Pubmed
Malhotra,
Low plasma albumin linked to fluid overload in postoperative epidural patients.
2009,
Pubmed
Margarson,
Serum albumin: touchstone or totem?
1998,
Pubmed
Murat,
Impact of Serum Albumin Levels on Contrast-Induced Acute Kidney Injury in Patients With Acute Coronary Syndromes Treated With Percutaneous Coronary Intervention.
2015,
Pubmed
Nada,
Low hemoglobin levels are independently associated with neonatal acute kidney injury: a report from the AWAKEN Study Group.
2021,
Pubmed
Nicholson,
The role of albumin in critical illness.
2000,
Pubmed
Roche,
The antioxidant properties of serum albumin.
2008,
Pubmed
Ruopp,
Youden Index and optimal cut-point estimated from observations affected by a lower limit of detection.
2008,
Pubmed
Selewski,
Acute kidney injury in asphyxiated newborns treated with therapeutic hypothermia.
2013,
Pubmed
Selewski,
The impact of fluid balance on outcomes in critically ill near-term/term neonates: a report from the AWAKEN study group.
2019,
Pubmed
Selewski,
The impact of fluid balance on outcomes in premature neonates: a report from the AWAKEN study group.
2020,
Pubmed
Shao,
Hypoalbuminemia: a risk factor for acute kidney injury development and progression to chronic kidney disease in critically ill patients.
2017,
Pubmed
Shum,
Septic acute kidney injury in critically ill patients - a single-center study on its incidence, clinical characteristics, and outcome predictors.
2016,
Pubmed
Torer,
Association of Serum Albumin Level and Mortality in Premature Infants.
2016,
Pubmed
Walther,
Serum albumin concentration and risk of end-stage renal disease: the REGARDS study.
2018,
Pubmed
Watchko,
Prevalence of Hypoalbuminemia and Elevated Bilirubin/Albumin Ratios in a Large Cohort of Infants in the Neonatal Intensive Care Unit.
2017,
Pubmed
Wiedermann,
Hypoalbuminemia and acute kidney injury: a meta-analysis of observational clinical studies.
2010,
Pubmed
Wiedermann,
Causal relationship between hypoalbuminemia and acute kidney injury.
2017,
Pubmed
Zappitelli,
Developing a neonatal acute kidney injury research definition: a report from the NIDDK neonatal AKI workshop.
2017,
Pubmed