Prognostic Significance of the Albumin to Fibrinogen Ratio in Peritoneal Dialysis Patients

Front Med (Lausanne). 2022 Apr 28:9:820281. doi: 10.3389/fmed.2022.820281. eCollection 2022.

Abstract

Background: Albumin to fibrinogen ratio (AFR) is a demonstrated predictor of mortality in various diseases. The aim of this study was to evaluate the prognostic value of AFR to predict mortality in peritoneal dialysis (PD) patients.

Methods: We retrospectively analyzed 212 incident PD patients from January 2010 to December 2017 and followed them until December 2019. We used receiver operating curve (ROC) analysis to determine the optimal cut-off point for AFR at baseline to predict overall and cardiovascular mortality during the follow-up period. Kaplan-Meier curve and Cox regression analysis were applied to evaluate the association between AFR and all-cause and cardiovascular mortality.

Results: The optimal threshold for AFR to predict mortality was 8.48. A low AFR was strongly correlated with worse all-cause and cardiovascular mortality in PD patients. Multivariate analysis revealed that elevated AFR was an independent marker predicting reduced all-cause and cardiovascular mortality (HR 2.41, 95% CI 1.11-5.22, P = 0.026; and HR 2.18, 95% CI 1.21-3.95, P = 0.010, respectively).

Conclusions: Patients with a high AFR had reduced all-cause and cardiovascular mortality. AFR is a potential prognostic biomarker in PD patients.

Keywords: albumin; biomarker; fibrinogen; peritoneal dialysis (PD); prognosis.