Immunoglobulins, represent a major portion of the globulin involved in immunologic and inflammatory processes. A low serum albumin level is a key characteristic of protein-energy wasting (PEW), which is common and an important risk factor for morbidity and mortality in patients on dialysis. Serum albumin can reflect both inflammatory and malnourished status. Īlbumin functions include maintaining plasma colloid osmotic pressure, transporting substances, and acting as an antioxidant. The albumin-globulin ratio (AGR), frequently reported in the comprehensive blood panel, calculated with the following equation: AGR = Albumin /, is actually a reflection of all non-albumin proteins, which includes globulin and other prothrombotic proteins and inflammatory proteins. The measured serum total protein includes albumin, globulin and prothrombotic proteins, prothrombin, fibrinogen, and other inflammatory proteins (e.g, C-reactive protein, interleukins, leukotrienes, and others). Hong Kong, which has the largest proportion of PD patients in the world, reported that the overall 5-years cumulative survival for PD patients was 50.7% in 2012 therefore, the risk factors associated with the mortality of PD patients are discommode. Although there are some advantages of PD, the survival rate of PD patients remains inadequate. Peritoneal dialysis (PD) is an effective therapy for ESRD. It was reported that the population of ESRD patients was more than 762,331 in 2016 according to the US Renal Data System 2018 Annual Data Report.
There is an increasing number of end-stage renal disease (ESRD) patients around the world. AGR may be a useful index in identifying patients on PD at risk for CVD and all-cause of mortality. Patients with a low AGR level had an increased all-cause and cardiovascular mortality. After adjusting for potential confounders, the lower AGR level was significantly associated with an increased all-cause and cardiovascular mortality. Kaplan-Meier curves showed that patients with AGR > 1.26 had better rates of survival than those with AGR ≤ 1.25 ( p < 0.001). During follow-up, 131 (21.8%) patients died, including 57 patients (43.5%) who died due to cardiovascular diseases. The median follow-up time was 32.17 (interquartile range = 32.80) months. Kaplan-Meier curves and multivariate Cox regression models were applied to analyze the association between AGR and all-cause of mortality and cardiovascular mortality. We retrospectively analyzed 602 incident PD patients from January 1st, 2008, to December 31st, 2017, at our center and followed them until December 31st, 2018. The aim of this study was to evaluate the prognostic value of AGR on peritoneal dialysis (PD) patients. Albumin-globulin ratio (AGR), a variable based on serum albumin and non-albumin proteins, has been demonstrated as a predictor of mortality in patients with malignant neoplasm.
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