Serum C-reactive protein to albumin ratio and mortality associated with peritoneal dialysis

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Background Serum C-reactive protein to albumin ratio (CAR) was recently identified as a poor marker of prognosis among various populations. The current study aimed to examine the association between CAR and all-cause mortality among patients undergoing peritoneal dialysis (PD).Methods A total of 758 patients with PD were included in this study during the period from 1 November 2005 to 28 February 2017 and followed up until 31 May 2017. The primary outcome was all-cause mortality. We used multivariate Cox proportional hazard models and Kaplan-Meier survival curves to assess the relationship between CAR and all-cause mortality in these patients.Results Among 758 participants, mean age was 49.1 ± 14.2 years, with 56% males and 18.6% prevalence of diabetes. Median CAR was 0.13 (interquartile range [IQR], 0.07–0.34). After 27 months (IQR, 14–40 months) of follow-up, 157 deaths had been reported. After adjusting for confounding factors, we found a significant association between serum CAR and all-cause mortality among those in the highest CAR group (hazard ratio 1.91, 95% confidence interval 1.05– 3.47, p = 0.034).Conclusions In patients undergoing PD, an increase in serum CAR is independently associated with increased risk for all-cause mortality.