Clinical Report: Serum Albumin Trajectories and Outcomes in Early SA-AKI

Overview

This study investigates the relationship between serum albumin trajectories and clinical outcomes in critically ill patients with early sepsis-related acute kidney injury (SA-AKI). Five distinct trajectory subgroups of serum albumin levels were identified.

Background

Sepsis is a major public health issue with high mortality rates, particularly in intensive care unit (ICU) patients. Sepsis-associated acute kidney injury (SA-AKI) complicates the clinical course and is linked to poor outcomes.

Data Highlights

Key Findings

• Five baseline-stratified trajectory subgroups of serum albumin levels were identified.
• Patients with a steady-state trajectory at 2.0 g/dL had significantly higher mortality risks at 30, 90, 180, and 365 days compared to the 3.0 g/dL group.
• Patients with a trajectory level of >4.1 g/dL exhibited increased 365-day mortality risk.
• Longer hospital length of stay was associated with lower albumin levels.
• Age and sex interacted with the association between serum albumin trajectories and mortality risk.

Clinical Implications

Monitoring serum albumin trajectories in critically ill patients with early SA-AKI may provide insights for risk stratification.

Conclusion

The study highlights the association of serum albumin trajectories with mortality risk and hospital length of stay in critically ill patients with early SA-AKI.

Related Resources & Content

1. Gao Q, et al., MIMIC-IV Database, 2023 -- Relationship Between Serum Albumin Trajectory Subgroups at Baseline and Clinical Outcomes in Critically Ill Patients with Early Sepsis-Related Acute Kidney Injury: A Retrospective Analysis
2. Intensive Care Medicine, 2020 -- Impact of Transient versus Persistent Acute Kidney Injury on Mortality and Host Response in Critically Ill Sepsis Patients: A Prospective Cohort Analysis
3. Conexiant, 2023 -- Albumin Therapy Tested in Septic Shock
4. Nature Reviews Nephrology, 2023 -- Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup
5. Intensive Care Medicine — The Relationship Between Hypoalbuminemia and Acute Kidney Injury: A Meta-Analysis of Observational Studies
6. Frontiers in Pediatrics — Association between the albumin-to-lymphocyte ratio and short-term mortality in critically Ill pediatric patients: a retrospective cohort study and machine learning analysis
7. Albumin Replacement in Patients With Severe Sepsis or Septic Shock - American College of Cardiology
8. Frontiers | Associations between serum albumin level trajectories and clinical outcomes in sepsis patients in ICU
9. Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup | Nature Reviews Nephrology