From the Guidelines
A low Albumin (A) to Globulin (G) ratio in blood results is significantly associated with increased risk of mortality and technique failure in patients with chronic renal failure.
Key Points
- A low serum albumin level is a strong predictor of poor outcomes, including technique failure and death, in patients with chronic renal failure 1.
- Serum albumin concentration is an important indicator of protein-energy nutritional status and visceral protein pool size in maintenance dialysis patients 2.
- A serum albumin level below the normal range (approximately 4.0 g/dL) is associated with malnutrition and increased mortality risk 2.
- The presence of comorbid conditions, such as diabetes, and catabolic illness can reduce albumin synthesis and increase albumin degradation, leading to a low serum albumin level 1.
- Regular monitoring of serum albumin concentration, at least every 4 months, is recommended to evaluate the patient's overall clinical status and nutritional status 1.
- Maintaining an optimal serum albumin level through adequate nutrition, prevention and treatment of catabolic illness, and maintenance of Kt/Vurea and creatinine is crucial for improving patient outcomes 1.
From the Research
Significance of a Low Albumin to Globulin Ratio
- A low albumin to globulin (A/G) ratio has been associated with various health conditions, including liver disease, cancer, and vascular adverse events 3, 4, 5.
- In liver disease, a low A/G ratio is often seen due to a decrease in serum albumin and an increase in globulins 3.
- A low A/G ratio has been found to be a negative prognostic factor in patients with surgically treated cervical cancer, with a ratio of <1.345 being significantly associated with poor prognosis 4.
- Genome-wide association studies have identified genetic variants associated with the A/G ratio, including variants in the TNFRSF13B and FADS1 loci 5.
Prognostic Value of A/G Ratio
- A low A/G ratio has been found to be associated with poor outcomes in patients with acute ischemic stroke, with a lower 7-day A/G ratio being independently associated with a poor outcome 6.
- In patients with hepatocellular carcinoma, a low preoperative A/G ratio has been found to be an independent predictor of overall survival, with a ratio of <1.16 being significantly associated with poor OS 7.
- The A/G ratio may serve as a prognostic marker for predicting worse prognosis in various diseases, including cancer and liver disease 4, 7.
Clinical Implications
- Monitoring the A/G ratio may be important for assessing inflammation and nutritional status in patients with various diseases 6.
- A low A/G ratio may indicate a poor prognosis and may be used to guide treatment decisions and stratification 4, 7.
- Further studies are needed to fully understand the clinical implications of a low A/G ratio and its potential use as a prognostic marker 3, 5.