albumin - publications
Serum Albumin as Predictor of Nutritional Status in Patients with ESRD.
Clin J Am Soc Nephrol. 2012 Jun 21;
Authors: Gama-Axelsson T, HeimbÃÂ¼rger O, Stenvinkel P, BÃÂ¡rÃÂ¡ny P, Lindholm B, Qureshi AR
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, 54ÃÂ±13 years; GFR, 6.6ÃÂ±0.3 ml/min per 1.73 m(2); recruited 1994-2010) and 383 prevalent (56% male; mean age, 62ÃÂ±14 years; recruited 1989-2004) dialysis patients. RESULTS: In incident patients, serum albumin was correlated with age (ÃÂ² =-0.15; P<0.001), diabetes (ÃÂ²=-0.30; P<0.001), high-sensitivity C-reactive protein (ÃÂ² =-0.37; P<0.001), and urinary albumin excretion (ÃÂ²=-0.38; P<0.001) but less so with poor nutritional status (SGA score > 1; ÃÂ²=-0.19; P<0.001). In prevalent patients, serum albumin was correlated with age (ÃÂ²=-0.15; P<0.001), high-sensitivity C-reactive protein (ÃÂ²=-0.30; P<0.001), diabetes (ÃÂ²=-0.31; P<0.001), and SGA score > 1 (ÃÂ²=-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.
PMID: 22723451 [PubMed - as supplied by publisher]