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The albumin–bilirubin (ALBI) score predicts renal function decline in patients with diabetic kidney disease

diabetes-and-endocrinology
evidence-based-medicine
internal-medicine
nephrology
pathology

Abstract

Background: The albumin–bilirubin (ALBI) score, originally developed to assess hepatic reserve, has shown prognostic value in liver and systemic diseases. Whether ALBI predicts DKD progression, however, has not been established.

Methods: We conducted a retrospective single-center study including 126 patients with DKD hospitalized between January 2016 and May 2023. The ALBI score was calculated from serum albumin and total bilirubin. Patients were followed for 2–7 years, and DKD progression was evaluated by annual percentage change in estimated glomerular filtration rate (eGFR). Associations between ALBI quartiles and renal outcomes were assessed using correlation analyses, logistic regression, and receiver operating characteristic (ROC) curves.

Results: Higher ALBI scores were independently associated with a more rapid annual decline in eGFR. Patients in the highest ALBI quartiles exhibited significantly faster eGFR loss and increased urinary protein excretion compared with lower quartiles. Correlation analysis showed that ALBI was negatively associated with annual percentage change in eGFR (rs = –0.255, p = 0.004). ROC analysis identified –2.24 as the optimal ALBI cut-off for predicting DKD progression (AUC = 0.662, p = 0.002). After multivariable adjustment, higher ALBI quartiles remained significantly associated with rapid eGFR decline (p for trend = 0.002).

Conclusions: This study provides evidence that the ALBI score is a significant predictor of DKD progression.

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