Influence of C-Reactive Protein and Urinary Protein Excretion on Prediction of Graft Failure and Mortality by Serum Albumin in Renal Transplant Recipients

Rutger M. van Ree, Sascha Gross, Dorien M. Zelle, Jaap J. Homan van der Heide, Jan P. Schouten, Willem J. van Son, Reinold O. B. Gans, Stephan J. L. Bakker*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)

Abstract

Background. Hypoalbuminemia is an established predictor of poor outcome in renal transplant recipients (RTR). It is considered to reflect inflammation, poor nutritional status, or proteinuria. We explored the roles of high-sensitivity C-reactive protein (hsCRP) and urinary protein excretion in prediction of graft failure and mortality by serum albumin in RTR.

Methods. We included 605 RTR at a median (interquartile range) time of 6.0 years (2.5-11.5 years) after transplantation for baseline measurements.

Results. At baseline, urinary protein excretion (beta=-0.242, P

Conclusion. Low serum albumin concentrations predict graft failure and mortality in RTR independent of hsCRP and urinary protein excretion. The effect of serum albumin on graft failure is strongly modified by urinary protein excretion. These results suggest that chronic low-grade inflammation is not an important mechanism underlying inverse associations of serum albumin with graft failure and mortality. They also suggest that proteinuria is involved in the association of low serum albumin with graft failure.

Original languageEnglish
Pages (from-to)1247-1254
Number of pages8
JournalTransplantation
Volume89
Issue number10
DOIs
Publication statusPublished - 27-May-2010

Keywords

  • Serum albumin
  • Chronic transplant dysfunction
  • Graft survival
  • Mortality
  • Renal transplantation
  • CARDIOVASCULAR-DISEASE
  • HEMODIALYSIS-PATIENTS
  • RISK-FACTORS
  • KIDNEY
  • DETERMINANTS
  • INFLAMMATION
  • SURVIVAL
  • IMPACT
  • RATIO
  • NUTRITION

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