Effect of serum albumin changes on mortality in patients with peritoneal dialysis: A joint modeling approach and personalized dynamic risk predictions

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dc.authorid0000-0003-3293-2104en_US
dc.authorid0000-0002-2223-7856en_US
dc.authorid0000-0003-3293-2104en_US
dc.authorid0000-0002-7024-7231en_US
dc.contributor.authorBaşol, Merve
dc.contributor.authorGöksülük, Dinçer
dc.contributor.authorSipahioğlu, Murat Hayri
dc.contributor.authorKaraağaoğlu, Ergün
dc.date.accessioned2023-06-14T11:05:14Z
dc.date.available2023-06-14T11:05:14Z
dc.date.issued2021en_US
dc.departmentBAİBÜ, Tıp Fakültesi, Temel Tıp Bilimleri Bölümüen_US
dc.description.abstractPeritoneal dialysis (PD) is a frequently used and growing therapy for end-stage renal diseases (ESRD). Survival analysis of PD patients is an ongoing research topic in the field of nephrology. Several biochemical parameters (e.g., serum albumin, creatinine, and blood urea nitrogen) are measured repeatedly in the follow-up period; however, baseline or averaged values are primarily associated with mortality. Although this strategy is not incorrect, it leads to information loss, resulting in erroneous conclusions and biased estimates. This retrospective study used the trajectory of common renal function indexes in PD patients and mainly investigated the association between serum albumin change and mortality. Furthermore, we considered patient-specific variability in serum albumin change and obtained personalized dynamic risk predictions for selected patients at different follow-up thresholds to investigate the effect of serum albumin trajectories on patient-specific mortality. We included 417 patients from the Erciyes University Nephrology Department whose data were retrospectively collected using medical records. A joint modeling approach for longitudinal and survival data was used to investigate the relationship between serum albumin trajectory and mortality of PD patients. Results showed that averaged serum albumin levels were not associated with mortality. However, serum albumin change was significantly and inversely associated with mortality (HR: 2.43, 95% CI: 1.48 to 4.16). Risk of death was positively associated with peritonitis rate, hemodialysis history, and the total number of comorbid and renal diseases with hazard ratios 1.74, 3.21, and 1.41. There was also significant variability between patients. The personalized risk predictions showed that overall survival estimates were not representative for all patients. Using the patient-specific trajectories provided better survival predictions within the follow-up period as more data become available in serum albumin levels. In conclusion, using the trajectory of risk predictors via an appropriate statistical method provided better predictive accuracy and prevented biased findings. We also showed that personalized risk predictions were much informative than overall estimations in the presence of significant patient variability. Furthermore, personalized estimations may play an essential role in monitoring and managing patients during the follow-up period.en_US
dc.identifier.citationBasol, M., Goksuluk, D., Sipahioglu, M. H., & Karaagaoglu, E. (2021). Effect of serum albumin changes on mortality in patients with peritoneal dialysis: a joint modeling approach and personalized dynamic risk predictions. BioMed research international, 2021.en_US
dc.identifier.doi10.1155/2021/6612464
dc.identifier.endpage10en_US
dc.identifier.issn2314-6133
dc.identifier.issn2314-6141
dc.identifier.pmid34337034en_US
dc.identifier.scopus2-s2.0-85112130786en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage1en_US
dc.identifier.urihttp://dx.doi.org/10.1155/2021/6612464
dc.identifier.urihttps://hdl.handle.net/20.500.12491/11116
dc.identifier.volume2021en_US
dc.identifier.wosWOS:000683451000001en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.institutionauthorBaşol, Merve
dc.language.isoenen_US
dc.publisherHindawi Ltden_US
dc.relation.ispartofBioMed Research Internationaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectTechnique Failureen_US
dc.subjectTechnique Survivalen_US
dc.subjectTransporten_US
dc.subjectOutcomesen_US
dc.subjectCapden_US
dc.subjectExperienceen_US
dc.titleEffect of serum albumin changes on mortality in patients with peritoneal dialysis: A joint modeling approach and personalized dynamic risk predictionsen_US
dc.typeArticleen_US

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