Serum Albumin as Predictor of Nutritional Status in Patients with ESRD
Adult
Inflammation
Male
2. Zero hunger
Hand Strength
Incidence
Age Factors
Middle Aged
3. Good health
Absorptiometry, Photon
Cross-Sectional Studies
Logistic Models
Cardiovascular Diseases
Creatinine
Multivariate Analysis
Diabetes Mellitus
Albuminuria
Humans
Kidney Failure, Chronic
Female
Biomarkers
Aged
DOI:
10.2215/cjn.10251011
Publication Date:
2012-06-23T00:38:34Z
AUTHORS (6)
ABSTRACT
Summary
Background and objectives
Serum albumin is a widely used biomarker of nutritional status in patients with CKD; however, its usefulness is debated. This study investigated serum albumin and its correlation with several markers of nutritional status in incident and prevalent dialysis patients.
Design, setting, participants, & measurements
In a cross-sectional study, serum albumin (bromocresol purple), and other biochemical (serum creatinine), clinical (subjective global assessment [SGA]), anthropometric (handgrip strength; skinfold thicknesses), and densitometry (dual-energy x-ray absorptiometry) markers of nutritional status were assessed in 458 incident (61% male; mean age, 54±13 years; GFR, 6.6±0.3 ml/min per 1.73 m2; recruited 1994–2010) and 383 prevalent (56% male; mean age, 62±14 years; recruited 1989–2004) dialysis patients.
Results
In incident patients, serum albumin was correlated with age (β =−0.15; P<0.001), diabetes (β=−0.30; P<0.001), high-sensitivity C-reactive protein (β =−0.37; P<0.001), and urinary albumin excretion (β=−0.38; P<0.001) but less so with poor nutritional status (SGA score > 1; β=−0.19; P<0.001). In prevalent patients, serum albumin was correlated with age (β=−0.15; P<0.001), high-sensitivity C-reactive protein (β=−0.30; P<0.001), diabetes (β=−0.31; P<0.001), and SGA score > 1 (β=−0.16; P<0.001). In predicting nutritional status assessed by SGA and other markers, adding serum albumin to models that included age, sex, diabetes, and cardiovascular disease did not significantly increase explanatory power.
Conclusions
In incident and prevalent dialysis patients, serum albumin correlates poorly with several markers of nutritional status. Thus, its value as a reliable marker of nutritional status in patients with ESRD is limited.
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