Baseline Serum Albumin for Long-Term Risk Stratification in Maintenance Hemodialysis Patients: A Retrospective Cohort Study

Background/Objectives: Mortality among patients receiving maintenance hemodialysis remains high, and biomarkers that allow early risk stratification are needed. Serum albumin reflects nutritional status and systemic inflammation and has been associated with adverse outcomes; however, its long-term prognostic significance remains incompletely defined. This study examined the association between baseline serum albumin and long-term (up to 10-year) all-cause mortality in a large hemodialysis cohort. Methods: This retrospective cohort study included adult patients undergoing maintenance hemodialysis between 2015 and 2025 at a tertiary nephrology center. Individuals with at least three months of stable dialysis and available baseline serum albumin measurements were included. Patients were categorized into two groups according to baseline serum albumin levels (