The Effect of Serum Albumin at the Start of Continuous Ambulatory Peritoneal Dialysis Treatment on Patient Survival

Objective To analyze the effect of serum albumin using immunoturbidimetry, demographic, biochemical, and kinetic factors on survival of continuous ambulatory peritoneal dialysis (CAPD) patients.Design A review of prospectively collected data in a 2-year follow-up study of peritoneal transport kinetics.Setting University medical center.Participants Sixty-one patients, evaluated within 3 months after the start of CAPD.Main Outcome Measures Covariables used in the survival analysis were plasma urea, and creatinine, albumin, hemoglobin, mass transfer area coefficient of creatinine, peritoneal albumin clearance, 4-hour peritoneal albumin loss, net ultrafiltration, age, blood pressure, body mass index, difference between actual and ideal body weight, and presence or absence of systemicdisease.Results Overall survival was 64% at 2 years. Median serum albumin was 30.9 g/L, range 18.1 -43.9 g/L. Patients with a serum albumin below the median had a lower survival rate than those higher than the median (2-year survival 49% vs 79%, p = 0.01). Using the Cox model, survival was related to systemic disease (p = 0.004), age (p = 0.02), hemoglobin (p = 0.03), and serum albumin (p = 0.1).Conclusions The results confirm the strength of serum albumin as predictor of survival. However, in this study serum albumin merely reflected the presence of a systemic disease, which was the most important risk factor for patient survival.