title: Acute phase proteins and peritoneal dialysate albumin loss are the main determinants of serum albumin in peritoneal dialysis patients.
abstract: Hypoalbuminemia predicts mortality in dialysis patients. It has been postulated that hypoalbuminemia in the dialysis population is a consequence of poor protein intake resulting from inadequate dialysis. To establish the cause of hypoalbuminemia in a group of 27 patients on peritoneal dialysis (PD), we determined the relationship between serum albumin concentration and a group of parameters including dialysis dose delivered (Kt/V), normalized protein catabolic rate (PCRn), transperitoneal and urinary albumin losses, and the serum concentration of two acute-phase proteins, C-reactive protein (CRP), and serum amyloid A (SAA). Serum albumin concentration could be predicted by a combination of transperitoneal albumin loss and either the serum concentration of CRP or of SAA. There was no relationship between weekly Kt/V or PCRn and serum albumin concentration. CRP and SAA significantly correlated with one another, but neither correlated with transperitoneal albumin losses. Hypoalbuminemia in PD patients is a consequence of transperitoneal albumin losses and of the acute phase response.
authors.affiliation: Department of Medicine, University of California Davis, Sacramento 95817, USA. jyyeun@ucdavis.edu
authors.forename: J Y
authors.initials: JY
authors.lastname: Yeun
authors.forename: G A
authors.initials: GA
authors.lastname: Kaysen
mesh_terms: D000210:Acute-Phase Reaction / Q000097:blood / Q000652:urine; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000032:analysis*; D000419:Albuminuria / Q000652:urine; D002097:C-Reactive Protein / Q000032:analysis*; D015314:Dialysis Solutions / Q000008:administration & dosage / Q000032:analysis*; D004044:Dietary Proteins / Q000008:administration & dosage / Q000378:metabolism; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010537:Peritoneum / Q000378:metabolism; D011506:Proteins / Q000378:metabolism; D012709:Serum Albumin / Q000032:analysis*; D000685:Serum Amyloid A Protein / Q000032:analysis*; D015996:Survival Rate
chemical_list: D000418:Albumins; D015314:Dialysis Solutions; D004044:Dietary Proteins; D011506:Proteins; D012709:Serum Albumin; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein