Aging and death-associated changes in serum albumin variability over the course of chronic hemodialysis treatment

Autor: Hiromi Shimoyama, Akihisa Watanabe, Yuichi Nakazato, Riichi Kurane, Satoru Hirose
Rok vydání: 2017
Předmět:
Male
Aging
Physiology
030232 urology & nephrology
030204 cardiovascular system & hematology
Biochemistry
0302 clinical medicine
Endocrinology
Mathematical and Statistical Techniques
Interquartile range
Epidemiology
Chronic Kidney Disease
Medicine and Health Sciences
Homeostasis
Multidisciplinary
biology
Frailty
Middle Aged
Death
Nephrology
Physical Sciences
Medicine
Regression Analysis
Female
Statistics (Mathematics)
Research Article
medicine.medical_specialty
Endocrine Disorders
Coefficient of variation
Science
Serum albumin
Linear Regression Analysis
Research and Analysis Methods
03 medical and health sciences
Renal Dialysis
Diabetes mellitus
Albumins
Linear regression
Medical Dialysis
medicine
Diabetes Mellitus
Humans
Chronic hemodialysis
Statistical Methods
Serum Albumin
Demography
Models
Statistical
business.industry
Albumin
Biology and Life Sciences
Proteins
medicine.disease
Geriatrics
Metabolic Disorders
biology.protein
business
Physiological Processes
Mathematics
Zdroj: PLoS ONE
PLoS ONE, Vol 12, Iss 9, p e0185216 (2017)
ISSN: 1932-6203
Popis: BackgroundSeveral epidemiological studies have demonstrated associations between variability in a number of biological parameters and adverse outcomes. As the variability may reflect impaired homeostatic regulation, we assessed albumin variability over time in chronic hemodialysis (HD) patients.MethodsData from 1346 subjects who received chronic HD treatment from May 2001 to February 2015 were analyzed according to three phases of HD treatment: post-HD initiation, during maintenance HD treatment, and before death. The serum albumin values were grouped according to the time interval from HD initiation or death, and the yearly trends for both the albumin levels and the intra-individual albumin variability (quantified by the residual coefficient of variation: Alb-rCV) were examined. The HD initiation and death-associated changes were also analyzed using generalized additive mixed models. Furthermore, the long-term trend throughout the maintenance treatment period was evaluated separately using linear regression models.ResultsAlbumin levels and variability showed distinctive changes during each of the 3 periods. After HD initiation, albumin variability decreased and reached a nadir within a year. During the subsequent maintenance treatment period (interquartile range = 5.2-11.0 years), the log Alb-rCV showed a significant upward trend (mean slope: 0.011 ± 0.035 /year), and its overall mean was -1.49 ± 0.08 (equivalent to an Alb-rCV of 3.22%). During the 1-2 years before death, this upward trend clearly accelerated, and the mean log Alb-rCV in the last year of life was -1.36 ± 0.17. The albumin levels and variability were negatively correlated with each other and exhibited exactly opposite movements throughout the course of chronic HD treatment. Different from the albumin levels, albumin variability was not dependent on chronological age but was independently associated with an individual's aging and death process.ConclusionThe observed upward trend in albumin variability seems to be consistent with a presumed aging-related decline in homeostatic capacity.
Databáze: OpenAIRE
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