Hypoalbuminemia at admission predicts the development of acute kidney injury in hospitalized patients: A retrospective cohort study

BackgroundDevelopment of acute kidney injury (AKI) is common and is associated with poor outcomes. We aimed to determine whether hypoalbuminemia (HA) at admission could be a risk factor for the development of AKI and mortality in hospitalized patients.MethodsWe enrolled patients who were admitted to Seoul National University Bundang Hospital from January 2013 to December 2013. HA at admission was defined as a serum albumin level ResultsA total of 19,472 patients were enrolled and divided into HA and normoalbuminemia (NA) groups at admission. The incidence of AKI was 10.7% (340/3179) in the HA group and 4.1% (662/16293) in the NA group (adjusted odds ratio [OR], 1.243; 95% confidence interval [CI], 1.069–1.445; P = 0.005). The hazard ratios for the 30-day, 90-day, and 1-year mortality were 1.873 (95% CI, 1.383–2.537; P P P P = 0.001). The mortality rate was not different according to albumin replacement.ConclusionsHA is associated with the development of AKI and high mortality in hospitalized patients. Replacement of albumin after the development of AKI may contribute to renal recovery. Further clinical trials are warranted.