Association between albumin-to-globulin ratio and long-term mortality in patients with chronic kidney disease: a cohort study.

PURPOSE

To examine whether albumin-to-globulin ratio (AGR) is correlated with long-term mortality in patients with chronic kidney disease (CKD), we performed this study using data from the National Health and Nutrition Examination Survey through 1999-2006.

METHODS

3302 CKD patients were included. Patients' baseline characteristics were collected. Multivariate Cox proportional hazards models were used to investigate the association between AGR and the study outcomes, including long-term all-cause and cardiovascular mortality. Subgroup analysis using the Cox proportional hazards model was performed as a sensitivity test.

RESULTS

During a median follow-up duration of 122.00 months, 1627 (49.27%) deaths were recorded and 440 patients died from cardiovascular disease. In adjusted model 1, AGR ≥ 1.26 group was associated with a lower risk of long-term all-cause mortality HR 0.72, 95% CI 0.65-0.81) compared with AGR < 1.26 group. A similar result was obtained in adjusted model 2. In adjusted model 1, AGR ≥ 1.08 group was associated with a lower risk of long-term cardiovascular mortality (HR 0.59, 95% CI 0.45-0.78) compared with AGR < 1.08 group. In adjusted model 2, there was no significant association between AGR ≥ 1.08 group and a decreased risk of long-term cardiovascular mortality (HR 0.82, 95% CI 0.95-1.12) compared with AGR < 1.08 group. The association of AGR with long-term all-cause mortality differed by gender and age while the association of AGR with long-term cardiovascular mortality differed by age after multivariate adjustment.

CONCLUSION

AGR is a potential biomarker in risk predictions for long-term mortality in CKD patients, especially in males under age 65.