Investigating the Prognostic Value of Serum Albumin Levels in Patients Undergoing Hemodialysis: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Background: Hypoalbuminemia, characterized by low serum albumin levels, is frequently observed in patients undergoing hemodialysis and has been identified as a potential predictor of increased mortality risk. This systematic review aims to evaluate the relationship between hypoalbuminemia and mortality in hemodialysis patients, assessing the prognostic value of serum albumin levels as an indicator for patient outcomes. Methods: A comprehensive search was conducted in databases including PubMed, Europe PMC, and Scopus to identify relevant studies. Studies were included if they investigated the association between serum albumin levels and mortality outcomes in adult patients undergoing hemodialysis. Data extraction was performed independently by two reviewers, focusing on study characteristics, patient demographics, albumin levels, and mortality outcomes. Quality assessment of studies was conducted using the Newcastle-Ottawa Scale (NOS). Result: A total of eight studies, encompassing 45,178 hemodialysis patients with a mean age in the 50s, met the inclusion criteria. The studies had a combined male cohort of 22,501 individuals. The definition of hypoalbuminemia varied across studies, with cutoff values ranging from 3.0 to 3.9 g/dL. Follow-up durations spanned from as early as 3 months to a maximum of 6.1 years. The meta-analysis revealed a pooled hazard ratio (HR) of 1.08 (95% CI: 0.94–1.25), suggesting a non-significant association between hypoalbuminemia and increased mortality risk (P = 0.28). However, substantial heterogeneity was present (I² = 79%), indicating variability across studies. Conclusions: Hypoalbuminemia showed a non-significant association with mortality in hemodialysis patients, though variability across studies suggests further research is needed for clarity.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.037 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.036 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".