Xia Wenkai, Kuang Meisi, Li Chenyu, Yao Xiajuan, Chen Yan, Lin Jie, Hu Hong
Department of Nephrology, Jiangyin People's Hospital Affiliated to Nantong University, Jiangyin, China.
Nephrologisches Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-University Munich, Munich, Germany.
Front Med (Lausanne). 2022 Apr 28;9:820281. doi: 10.3389/fmed.2022.820281. eCollection 2022.
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.
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.
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, = 0.026; and HR 2.18, 95% CI 1.21-3.95, = 0.010, respectively).
Patients with a high AFR had reduced all-cause and cardiovascular mortality. AFR is a potential prognostic biomarker in PD patients.
白蛋白与纤维蛋白原比值（AFR）已被证实是多种疾病死亡率的预测指标。本研究的目的是评估AFR对预测腹膜透析（PD）患者死亡率的预后价值。
我们回顾性分析了2010年1月至2017年12月期间212例新发PD患者，并随访至2019年12月。我们使用受试者工作特征曲线（ROC）分析来确定基线时AFR预测随访期间全因死亡率和心血管死亡率的最佳切点。采用Kaplan-Meier曲线和Cox回归分析来评估AFR与全因死亡率和心血管死亡率之间的关联。
AFR预测死亡率的最佳阈值为8.48。低AFR与PD患者较差的全因死亡率和心血管死亡率密切相关。多因素分析显示，AFR升高是预测全因死亡率和心血管死亡率降低的独立指标（HR分别为2.41，95%CI为1.11-5.22，P=0.026；以及HR为2.18，95%CI为1.21-3.95，P=0.010）。
AFR高的患者全因死亡率和心血管死亡率降低。AFR是PD患者潜在的预后生物标志物。
