Evidence map›Paper›PMID 31218394›Full record

ArticlePediatric nephrology (Berlin, Germany)2019

Serum albumin and hospitalization among pediatric patients with end-stage renal disease who started dialysis therapy.

Yusuke Okuda, Yoshitsugu Obi, Elani Streja, Marciana Laster, Connie Rhee, Craig B Langman, Stephanie M Jernigan, Isidro B Salusky, Francesca Tentori, Martin J Schreiber and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Yusuke OkudaHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, School of Medicine, University of California Irvine, 101 The City Drive South, City Tower, Suite 400, Orange, CA, 92868, USA.
Yoshitsugu ObiHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, School of Medicine, University of California Irvine, 101 The City Drive South, City Tower, Suite 400, Orange, CA, 92868, USA.
Elani StrejaHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, School of Medicine, University of California Irvine, 101 The City Drive South, City Tower, Suite 400, Orange, CA, 92868, USA.
Marciana LasterUniversity of California Los Angeles, Los Angeles, CA, USA.
Connie RheeHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, School of Medicine, University of California Irvine, 101 The City Drive South, City Tower, Suite 400, Orange, CA, 92868, USA.
Craig B LangmanFeinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Stephanie M JerniganEmory University School of Medicine, Atlanta, GA, USA.
Isidro B SaluskyUniversity of California Los Angeles, Los Angeles, CA, USA.
Francesca TentoriDaVita Clinical Research, Minneapolis, MN, USA.
Martin J SchreiberDaVita Clinical Research, Minneapolis, MN, USA.
Steven M BrunelliDaVita Clinical Research, Minneapolis, MN, USA.
Kamyar Kalantar-ZadehHarold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, School of Medicine, University of California Irvine, 101 The City Drive South, City Tower, Suite 400, Orange, CA, 92868, USA. kkz@uci.edu.

Funding

Transition of Care in CKD (TC-CKD)U01DK102163 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI JACOBSEN, STEVEN J, KALANTAR-ZADEH, KAMYAR · 2014 to 2018
$2.8M
MALNUTRITION, DIET AND RACIAL DISPARITIES IN CKDK24DK091419 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI KALANTAR-ZADEH, KAMYAR · 2011 to 2020
$1.8M
Hypothyroidism, Cardiovascular Health, and Survival in Kidney DiseaseK23DK102903 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI RHEE, CONNIE MEEYOUNG · 2014 to 2018
$955k
Translational Research Training in Pediatric NephrologyT32DK104687 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SALUSKY, ISIDRO B. · 2015 to 2019
$879k
A Pilot Feasibility Trial of Thyroid Hormone Replacement in Dialysis PatientsR03DK114642 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI RHEE, CONNIE MEEYOUNG · 2017 to 2018
$155k
NIDDK NIH HHS K23 DK102903NIDDK NIH HHS K24 DK091419NIDDK NIH HHS K24-DK091419NIDDK NIH HHS R03 DK114642NIDDK NIH HHS T32 DK104687NIDDK NIH HHS U01 DK102163
6 · The paper itself

Abstract

backgroundHypoalbuminemia is a strong predictor of hospitalization and mortality among adult dialysis patients. However, data are scant on the association between serum albumin and hospitalization among children new to dialysis.

methodsIn a retrospective cohort study of children 1-17 years old with end-stage renal disease receiving dialysis therapy in a large US dialysis organization 2007-2011, we examined the association of serum albumin with hospitalization frequency and total hospitalization days using a negative binomial regression model.

resultsAmong 416 eligible patients, median (interquartile range) age was 14 (10-16) years and mean ± SD baseline serum albumin level was 3.7 ± 0.8 g/dL. Two hundred sixty-six patients (64%) were hospitalized during follow-up with an incidence rate of 2.2 (95%CI, 1.9-2.4) admissions per patient-year. There was 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), and 2.7 (1.7-3.6) per patient-year among patients with serum albumin levels < 3.5, 3.5- < 4.0, 4.0- < 4.5, and ≥ 4.5 g/dL, respectively. Case mix-adjusted hospitalization 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 levels 3.0, 3.5, and 4.5 g/dL, respectively (reference: 4.0 g/dL). Similar trends were observed in hospitalization days. These associations remained robust against further adjustment for laboratory variables associated with malnutrition and inflammation.

conclusionsBoth high and low serum albumin were associated with higher hospitalization in children starting dialysis. Because the observed association is novel and not fully explainable especially for high serum albumin levels, interpreting the results requires caution and further studies are needed to confirm and elucidate this association before clinical recommendations are made.

Indexed as

AdolescentChildChild, PreschoolEnergy MetabolismFemaleHospitalizationHumansHypoalbuminemiaInfantKidney Failure, ChronicMaleRenal DialysisRetrospective StudiesSerum AlbuminSerum AlbuminHospitalizationHyperalbuminemiaHypoalbuminemiaIncident dialysis patientsProtein energy wasting

Identifiers

PMID31218394
PMCPMC6776669

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.