Causal relationship between hypoalbuminemia and acute kidney injury

Table 5 Included studies on cancer

Ref.	Population/setting	Study design	Overall study size	Albumin measurement	Hypoalbuminemia-related outcomes
					AKI/ARF	Mortality
Hsu et al[51]	HCC with ascites	Prospective, observational	591	Albumin < 3.3 g/dL	Independently associated with ARF: OR = 7.3 (95%CI: 1.47-35.7; P = 0.009)	ND
Kim et al[50]	Gastric cancer surgery	Retrospective, observational	4718	Preoperative albumin < 4.0 g/dL	Independent predictor of AKI: OR = 1.40 (95%CI: 1.11-1.77; P = 0.005)	ND
Mizuno et al[55]	Chemotherapy-induced hypotension	Retrospective, observational	972	Hypoalbuminemia defined as ≤ 3.5 g/dL	Associated with low BP: OR = 1.497 (95%CI: 1.070-2.095; P = 0.019). Low BP associated with AKI	ND
Lahoti et al[56]	AML or HR-MDS	Retrospective, observational	537	Albumin level at baseline (median 3.3 g/dL)	Hypoalbuminemia predictive of AKI: OR = 0.7 (95%CI: 0.5-0.99; P = 0.049)	ND
Haynes et al[57]	Multiple myeloma	Retrospective, observational	107	Albumin ≥ 3.5 g/dL vs < 3.5 g/dL	ND	Higher albumin predictive of survival: HR = 0.56 (95%CI: 0.35-0.91; P = 0.02)
Fischler et al[59]	Cancer	Retrospective, observational	103	Albumin level at start of CVVHDF	ND	Low albumin (median 2.5 g/dL vs 3.05 g/dL) associated with mortality: OR = 3.341 (95%CI: 1.229-9.077); P = 0.02

AKI: Acute kidney injury; AML: Acute myelogenous leukemia; ARF: Acute renal failure; BP: Blood pressure; CVVHDF: Continuous venovenous hemodiafiltration; HCC: Hepatocellular carcinoma; HR: Hazard ratio; HR-MDS: High-risk myelodysplastic syndrome; ND: Not disclosed; OR: Odds ratio.