Effect of hypoalbuminemia and parenteral nutrition on free water excretion and electrolyte-free water resorption.
OBJECTIVE
To measure the effect of human albumin supplementation during parenteral nutrition on serum albumin concentrations, colloid oncotic pressure, free water clearance, electrolyte-free water resorption, and sodium excretion.


METHODS
Prospective, randomized, controlled trial.


METHODS
Tertiary care center.


METHODS
Thirty adult, hypoalbuminemic patients who required parenteral nutrition.


METHODS
Parenteral nutrition (control) or parenteral nutrition plus human albumin 25 g/L as a continuous infusion (treatment) for a 5-day study period.


METHODS
On days 1 and 5, serum albumin concentration, colloid oncotic pressure, free water clearance, electrolyte-free water resorption, and sodium excretion were measured.


RESULTS
Serum albumin concentrations increased significantly from day 1 to day 5 in both groups (control: 2.0 +/- 0.1 [mean +/- SEM] vs. 2.3 +/- 0.1 g/dL [20 +/- 1 vs. 23 +/- 1 g/L], p = .02; treatment: 2.2 +/- 0.1 vs. 3.5 +/- 0.2 g/dL [22 +/- 1 vs. 35 +/- 2 g/L], p = .0001). Day 5 serum albumin concentrations were significantly higher in the treatment group compared with control (p = .0001). Colloid oncotic pressure increased significantly from day 1 to day 5 in the treatment group (17.8 +/- 0.8 vs. 25.1 +/- 1.0 mm Hg, p = .0001), and was significantly higher than control at day 5 (p = .0001). No significant differences were found for free water clearance, electrolyte-free water resorption, or sodium excretion within or between groups.


CONCLUSIONS
In hypoalbuminemic patients, human albumin supplementation during parenteral nutrition results in significant increases in serum albumin concentrations and colloid oncotic pressure, but has no apparent effect on free water clearance, electrolyte-free water resorption, or sodium excretion.
Wojtysiak
S L
SL
Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee, Memphis 38163.
Brown
R O
RO
Roberson
D
D
Powers
D A
DA
Kudsk
K A
KA
D000418:Albumins / Q000008:administration & dosage; D001806:Blood Urea Nitrogen; D003102:Colloids; D003422:Critical Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009318:Natriuresis; D009584:Nitrogen / Q000378:metabolism; D009997:Osmotic Pressure; D010288:Parenteral Nutrition; D012709:Serum Albumin / Q000032:analysis*; D014556:Urine; D014882:Water-Electrolyte Balance
D000418:Albumins; D003102:Colloids; D012709:Serum Albumin; D009584:Nitrogen