Human albumin infusion and risk of acute kidney injury in adults with nephrotic syndrome due to minimal change disease: A single-center retrospective study.

Abstract

Background: The use of human albumin in patients with minimal change disease (MCD) remains controversial. The aim of the current study was to assess whether infusion of human albumin increased the risk of acute kidney injury (AKI) in adult patients with MCD.

Materials and methods: Adult patients who underwent renal biopsy for the diagnosis of MCD at the center between 2017 and 2022 were screened. Logistic regression and Nelson-Aalen cumulative risk curve analysis were used to compare data from patients with and without human albumin infusion.

Results: A total of 190 adult patients with MCD diagnosed by renal biopsy were included, of whom 45 received human albumin infusion before MCD diagnosis and 34 developed AKI within 4 weeks of MCD diagnosis. Nelson-Aalen cumulative risk curve analysis showed that patients who received human albumin infusion had a longer time to partial or complete response (p < 0.001), were more likely to develop AKI (p < 0.001), and were more likely to relapse (p = 0.002) than those who did not receive human albumin infusion. Multivariate logistic regression analysis showed that human albumin infusion was an independent risk factor for AKI in adult patients with MCD after adjusting for confounding factors (OR = 3.259, 95% CI, 1.209 - 8.780, p = 0.020).

Conclusion: Receiving human albumin infusions may be associated with the development of AKI in adult patients with MCD. Adult MCD patients who received human albumin infusion had a longer time to achieve partial or complete remission and were more likely to relapse.