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The impact of hypoalbuminemia in kidney-pancreas transplant recipients.

Publication ,  Journal Article
Becker, BN; Becker, YT; Heisey, DM; Leverson, GE; Collins, BH; Odorico, JS; D'Alessandro, AM; Knechtle, SJ; Pirsch, JD; Sollinger, HW
Published in: Transplantation
July 15, 1999

BACKGROUND: Hypoalbuminemia is associated with poorer outcomes in renal transplantation. Diabetes can compound hypoalbuminemia's detrimental effects. Kidney-pancreas transplantation alters the diabetic milieu; yet, some patients continue to be hypoalbuminemic. METHODS: We retrospectively analyzed 232 patients who underwent simultaneous kidney-pancreas transplantation (SPK) between 1993 and 1997 to determine the incidence and clinical correlates of hypoalbuminemia in SPK recipients. Post-SPK hypoalbuminemia was defined as a serum albumin level < or =3.5 g/dl. Univariate analyses were performed to determine whether post-SPK hypoalbuminemia was associated with pre-SPK variables. The effect of albumin level and hypoalbuminemia on the risk of post-SPK events (cardiac events, cytomegalovirus [CMV] infection, rejection, readmission, kidney and pancreas graft failure, and death) was examined with a Cox proportional hazards model. RESULTS: The study population consisted of 149 men and 83 women. Average follow-up was 2.0+/-1.3 years. Hypoalbuminemia (serum albumin level < or =3.5 g/dL) was most common early after SPK (3 months: 44% of evaluable patients were hypoalbuminemic; 12 months: 15.3%; 36 months: 8.3%). Acute rejection episodes and readmission were the most common adverse events after SPK transplantation. There were 24 episodes of renal allograft loss and only 5 cardiac events. Ten SPK recipients died during the study time period. SPK-related hypoalbuminemia was associated with an increased risk for CMV infection (risk ratio [RR] 2.5; P<0.02), renal graft failure (RR 2.41; P=0.05), pancreas graft failure (RR 3.66; P=0.01), and a trend toward an increased risk for death (RR 2.8; P=0.19). CONCLUSIONS: Post-SPK hypoalbuminemia resolves over time in many patients. Persistent post-SPK hypoalbuminemia is associated with an increased risk for CMV infection, graft loss, and a trend toward decreased survival. Efforts to improve nutrition, as it may affect hypoalbuminemia in SPK recipients, may be one strategy for improving SPK outcomes.

Duke Scholars

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

July 15, 1999

Volume

68

Issue

1

Start / End Page

72 / 75

Location

United States

Related Subject Headings

  • Surgery
  • Serum Albumin
  • Risk Factors
  • Pancreas Transplantation
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Humans
  • Graft Survival
  • Female
 

Citation

APA
Chicago
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MLA
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Becker, B. N., Becker, Y. T., Heisey, D. M., Leverson, G. E., Collins, B. H., Odorico, J. S., … Sollinger, H. W. (1999). The impact of hypoalbuminemia in kidney-pancreas transplant recipients. Transplantation, 68(1), 72–75. https://doi.org/10.1097/00007890-199907150-00014
Becker, B. N., Y. T. Becker, D. M. Heisey, G. E. Leverson, B. H. Collins, J. S. Odorico, A. M. D’Alessandro, S. J. Knechtle, J. D. Pirsch, and H. W. Sollinger. “The impact of hypoalbuminemia in kidney-pancreas transplant recipients.Transplantation 68, no. 1 (July 15, 1999): 72–75. https://doi.org/10.1097/00007890-199907150-00014.
Becker BN, Becker YT, Heisey DM, Leverson GE, Collins BH, Odorico JS, et al. The impact of hypoalbuminemia in kidney-pancreas transplant recipients. Transplantation. 1999 Jul 15;68(1):72–5.
Becker, B. N., et al. “The impact of hypoalbuminemia in kidney-pancreas transplant recipients.Transplantation, vol. 68, no. 1, July 1999, pp. 72–75. Pubmed, doi:10.1097/00007890-199907150-00014.
Becker BN, Becker YT, Heisey DM, Leverson GE, Collins BH, Odorico JS, D’Alessandro AM, Knechtle SJ, Pirsch JD, Sollinger HW. The impact of hypoalbuminemia in kidney-pancreas transplant recipients. Transplantation. 1999 Jul 15;68(1):72–75.

Published In

Transplantation

DOI

ISSN

0041-1337

Publication Date

July 15, 1999

Volume

68

Issue

1

Start / End Page

72 / 75

Location

United States

Related Subject Headings

  • Surgery
  • Serum Albumin
  • Risk Factors
  • Pancreas Transplantation
  • Middle Aged
  • Male
  • Kidney Transplantation
  • Humans
  • Graft Survival
  • Female