Limitations of serum albumin level as a marker of nutritional status in hemodialysis patients
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- DOI: https://doi.org/10.15562/bmj.v9i1.1515 |
- Published: 2020-04-01
Open Access & Peer Reviewed Multidisciplinary
Journal of Medical Sciences
Journal of Medical Sciences
Abstract
Introduction. Albumin is widely used to evaluate nutritional status. However, its usage on patients with chronic kidney disease (CKD) remains controversial. This study was conducted to determine whether serum albumin levels can be used indicator of nutritional status in end-stage CKD patients undergoing routine hemodialysis.
Methods. This cross-sectional study included 535 subjects who underwent hemodialysis twice per week in 2017 from three hospitals in Jakarta, Indonesia. Data were collected from the medical records of the subjects and analysed using descriptive statistics and mean comparisons of independent samples.
Results. Based on body mass index as a marker of nutritional status, the majority (85.9%) of subjects were not underweight. Almost an equal proportion of underweight subjects had normal serum albumin (15.1%) compared with hypoalbuminemia (14.4%). Hypoalbuminemia was found in 29.7% and 28.6% of non-underweight and underweight subjects, respectively. Moreover, there was no significant difference in serum albumin levels between underweight and non-underweight patients (p = 0.886, Mann-Whitney test).
Conclusions. Our data do not support a role for serum albumin level as a marker for nutritional status in CKD patients.
References
- Bharadwaj S, Ginoya S, Tandon P, et al. Malnutrition: Laboratory markers vs nutritional assessment. Gastroenterol Rep. 2016;4:272–280. Doi: 10.1093/gastro/gow013.
- Fouque D, Kalantar-Zadeh K, Kopple J, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73:391–398.
- Ikizler TA, Cano NJ, Franch H, et al. Prevention and treatment of protein energy wasting in chronic kidney disease patients: A consensus statement by the International Society of Renal Nutrition and Metabolism. Kidney Int. 2013;84:1096–1107.
- Takahashi R, Ito Y, Takahashi H, Ishii H, Kasuga H, Mizuno M, et al. Combined values of serum albumin, C-reactive protein, and body mass index at dialysis initiation accurately predicts long-term mortality. Am J Nephrol. 2012;36:136–143. DOI: 10.1159/000339940.
- Sastroasmoro S. Dasar-dasar metodologi penelitian klinis. Jakarta: CV. Sagung Seto; 2014.
- Bharadwaj S, Ginoya S, Tandon P, et al. Malnutrition: Laboratory markers vs nutritional assessment. Gastroenterol Rep. 2016;4:272–280. Doi: 10.1093/gastro/gow013.
- Lee JL, Oh ES, Lee RW, et al. Serum albumin and prealbumin in calorically restricted, non-diseased individuals: A systematic review. Am J Med. 2015;128:1023–1022.
- Haluzik M, Kabrt J, Nedvidkova J, et al. Relationship of serum leptin levels and selected nutritional parameters in patients with protein-caloric malnutrition. Nutrition. 1999;15:829–833.
- Friedman AN and Fadem SZ. Reassessment of albumin as a nutritional marker in kidney disease. J Am Soc Nephrol. 2010;21:223–230.
- Kaysen GA, Dubin JA, Muller HG, Mitch WE, Rosales LM, and Levin NW. Relationships among inflammation, nutrition, and physiologic mechanisms establishing albumin levels in hemodialysis patients. Kidney Int. 2002;61:2240–2249.
- Oshvandi K, Kavyanneja R, Borzuo SR, and Gholyaf M. High-flux and low-flux membranes: Efficacy in hemodialysis. Nurs Midwifery Stud. 2014;3:e21764.
How to Cite
Bawazir, L. A. A. (2020). Limitations of serum albumin level as a marker of nutritional status in hemodialysis patients. Bali Medical Journal, 9(1), 149–154. https://doi.org/10.15562/bmj.v9i1.1515
