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Causal relationship between hypoalbuminemia and acute kidney injury 被引量:17
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作者 Christian J wiedermann wolfgang wiedermann Michael Joannidis 《World Journal of Nephrology》 2017年第4期176-187,共12页
Our meta-analysis published in 2010 provided evidence that low levels of serum albumin (hypoalbuminemia) are a signifcant independent predictor of acute kidney injury (AKI) and death following AKI. Since then, a l... Our meta-analysis published in 2010 provided evidence that low levels of serum albumin (hypoalbuminemia) are a signifcant independent predictor of acute kidney injury (AKI) and death following AKI. Since then, a large volume of additional data from observational clinical studies has been published further evaluating the relationship between serum albumin and AKI occurrence. This is an updated review of the literature to re-evaluate the hypothesis that hypoalbuminemia is independently associated with increased AKI risk. Eligible studies published from September 2009 to December 2016 were sought in PubMed (MEDLINE) and forty-three were retained, the great majority being retrospective observational cohort studies. These included a total of about 68000 subjects across a diverse range of settings, predominantly cardiac surgery and acute coronary interventions, infectious diseases, transplant surgery, and cancer. Appraisal of this latest data set served to conclusively corroborate and confirm our earlier hypothesis that lower serum albumin is an independent predictor both of AKI and death after AKI, across a range of clinical scenarios. The body of evidence indicates that hypoalbuminemia may causally contribute to development of AKI. Furthermore, administration of human albumin solution has the po-tential to prevent AKI; a randomized, controlled study provides evidence that correcting hypoalbuminemia may be renal-protective. Therefore, measurement of serum albumin to diagnose hypoalbuminemia may help identify high-risk patients who may beneft from treatment with exogenous human albumin. Multi-center, prospective, randomized, interventional studies are warranted, along with basic research to define the mechanisms throughwhich albumin affords nephroprotection. 展开更多
关键词 Acute kidney injury Acute renal failure HYPOALBUMINEMIA MORTALITY PREVENTION
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