High Serum Albumin Levels were Associated with Acute Kidney Injury in Pediatric Surgical Intensive Care Units

Abstract

Introduction: There are limited studies revealing the association between serum albumin concentrations and acute kidney injury (AKI) in critically ill children.

Methods: This was a multicenter retrospective study. Children consecutively admitted to four pediatric surgical intensive care units (PSICUs) between January 2016 and December 2020 were screened for analysis. Patients without recorded albumin values during the PSICU stay were excluded. Data were extracted from the electronic medical records systems of the hospitals. AKI was defined according to the Kidney Disease Improving Global Outcome (KDIGO) guidelines. The associations between serum albumin levels and AKI were assessed by using logistic regression models.

Results: A total of 7802 children were included in the analysis. The median age of the children was 1.0 (interquartile range (IQR), 0.0-4.0) years. There were 3214 (41.2 %) children who developed AKI. In the univariate logistic regression model, serum albumin levels were associated with AKI (odds ratio (OR) = 1.04, 95 % confidence interval (CI) 1.04-1.05). After adjusting for covariates, serum albumin showed an independent association with AKI (OR = 1.04, 95 % CI 1.03-1.05). Albumin levels above 39.43 g/L (OR = 1.036, 95 % CI 1.002-1.070) were associated with AKI in the unadjusted cubic spline. In the adjusted cubic spline, albumin levels above 40.41 g/L (OR = 1.061, 95 % CI 1.003-1.122) were associated with AKI.

Conclusion: High serum albumin was associated with AKI in critically ill children in the PSICU. Further studies are needed to validate our findings.

Type of study: Prognostic Study.

Level of evidence: LEVEL II.

Keywords: Acute kidney injury; Albumin; Critical care; Pediatric.