title: Serum albumin: associations and significance in peritoneal dialysis.
abstract: Hypoalbuminemia in hemodialysis patients is a strong predictor of mortality; however, the significance of hypoalbuminemia in peritoneal dialysis patients is less well-defined. We have analyzed the factors associated with hypoalbuminemia in a cross-sectional study of 36 peritoneal dialysis patients, and investigated the impact of hypoalbuminemia on the one-year clinical outcome in 53 peritoneal dialysis patients. We found hypoalbuminemia to be associated with low values for the kinetic parameters KT/V, creatinine clearance, and normalized protein catabolic rate (nPCR) by univariant analysis. In a multiple regression model, nPCR was the only significant predictor of serum albumin. Clinical outcome measures evaluated were days-hospitalized, peritonitis rate, and death. Days-hospitalized was inversely correlated with serum albumin, and deaths occurred only in patients with serum albumin less than 4.0 mg/dL. There were no associations with peritonitis episodes. In conclusion, our study provides evidence that hypoalbuminemia in peritoneal dialysis patients is associated with a low protein intake measured by the nPCR and, possibly, with a low delivered dose of dialysis. Our study also suggests that the serum albumin level correlates to clinical outcome measured by days-hospitalized.
authors.affiliation: Mount Sinai Medical Center, New York, New York.
authors.forename: R G
authors.initials: RG
authors.lastname: Marcus
authors.forename: E
authors.initials: E
authors.lastname: Chaing
authors.forename: F
authors.initials: F
authors.lastname: Dimaano
authors.forename: J
authors.initials: J
authors.lastname: Uribarri
mesh_terms: D003404:Creatinine / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D010538:Peritonitis / Q000209:etiology; D011506:Proteins / Q000378:metabolism; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D011506:Proteins; D012709:Serum Albumin; D003404:Creatinine