Exploring the Relationship of Serum Albumin With Different Stages of Chronic Kidney Disease: A Cross Sectional Study in a Tertiary Care Hospital

Abstract

Background: Chronic Kidney Disease (CKD) represents a major global health concern, leading to serious outcomes such as progression to End-Stage Renal Disease (ESRD), complications arising from reduced kidney function, and a heightened risk of Cardiovascular Disease (CVD) Serum albumin is a marker of malnutrition as well as inflammation and has been demonstrated as a strong predictor of mortality in CKD and ESRD patients. Lower serum albumin concentrations may be an underappreciated risk factor for kidney function decline in elders. Many studies have hypothesized that lower levels and a progressive decline in serum albumin is associated with progressive CKD. The study’s objective is to explore the link of serum albumin on renal progression in CKD patients. Materials and methods: A cross-sectional study was conducted from January to December 2023 by the Department of Biochemistry, in collaboration with Department of Nephrology, at Marine City Medical College & Hospital (MCMCH). Purposive sampling method was implemented to recruit a total of 224 subjects, aged 18 years and above, following the inclusion and exclusion criteria, after obtaining approval from the Institutional Ethics Review Board (IERB). The study population was categorized into three groups based on the stages of CKD: stage III (eGFR 30–59 mL/min/1.73 m²), stage IV (eGFR 15–29 mL/min/1.73 m²), and stage V (eGFR <15 mL/min/1.73 m²). A detailed clinical profile was recorded for each of the subjects, including key biochemical parameters such as serum creatinine, serum albumin, and estimated Glomerular Filtration Rate (eGFR). Results: The study revealed Male predominance of 54% and females comprising 46% with the mean age of the subjects being 56.22 ± 12.78 years. The mean serum creatinine level and the eGFRshowed an inverse relation. The mean serum albumin level among the study population was 3.21 ± 0.55 g/dL, with a significant difference between males and females (p = 0.022). Among the 224 subjects, 74.1% (166) of the subjects had decreased serum albumin levels with majority of the subjects (131) falling under the category of CKD Stage V. It was also observed that among the recruited 224 subjects, 84% (188) had oedema, of which 147 (65.6%) had low serum albumin levels. ANOVA testrevealed that serum albumin levels progressively declined with advancing CKD stages, Stage III: 3.56 g/dL, Stage IV: 3.36 g/dL, Stage V: 3.11 g/dL (F= 11.68, p = 0.00001). A significant association was also found between decreased serum albumin and the presence of oedema (c² = 10.17, p = 0.0014). Conclusion: The study demonstrated a strong relationship between decreased serum albumin levels and decline in eGFR among the CKD subjects. Thus a significant positive correlation was established between the declined eGFR and decreased serum albumin levels in the study population. JCMCTA 2026 ; 37 (1) : 44-49