A slight decrease in serum albumin level is associated with rapid progression of kidney dysfunction even within the normal range: The Yuport Health Checkup Center Cohort Study

Abstract

AbstractObjectiveA low-normal albumin level is associated with a high risk of cardiovascular disease and mortality in the general population. However, the relationship between serum albumin level and future decline of kidney function is unclear. We aimed to clarify the effect of serum albumin level on the decline of kidney function in the general population.MethodsThe data used were from 11,000 participants of a voluntary health checkup program between 1998 and 2006 conducted in Japan. The primary outcome for kidney function was a difference in estimated glomerular filtration rate (ΔeGFR) of ≥3 mL/min/1.73 m2/year. The association of the risk of decreased kidney function with albumin level was determined using a logistic regression analysis. We fit separate multivariable logistic regressions for serum albumin levels (g/dL) as a continuous variable and as categorical data, classified as ≤4.3 (n=2,530), 4.4– 4.6 (n=5,427), and ≥4.7 (n=3,043).ResultsOf 11,000 participants, 346 had a ΔeGFR/year of ≥3. As compared with the participants with albumin levels of ≥4.7 g/dL, the risk of decline in kidney function was higher not only in those with albumin levels of ≤4.3 g/dL (adjusted OR = 2,29, 95% CI: 1.65–3.18) but also in 4.4-4.6 g/dL (adjusted OR = 1.60, 95% CI: 1.20–2.14).ConclusionDecreased albumin level is an independent risk factor for rapid decline in kidney function even within the normal range.