title: Postdialysis albumin: a better nutrition marker in pediatric hemodialysis patients?
abstract: BACKGROUND
  Prehemodialysis serum albumin is considered an important indicator of nutritional status in pediatric hemodialysis (HD) patients. Study aim To determine whether serum albumin levels changed significantly from predialysis to postdialysis, and correlated with fluid changes over HD treatment.
  
  
  METHODS
  We prospectively measured pre-HD and post-HD albumin levels in 9 pediatric patients (ages 10 to 20 years; mean age, 16.3 years) on HD over an 8-month period. Changes in weight and albumin over 45 HD treatments were compared.
  
  
  RESULTS
  A total of 66.7% of pre-HD and 100% of post-HD albumin levels were within the normal range. Post-HD albumin was significantly higher than pre-HD in 42 of 45 observations (Mean, 4.7 +/- 0.39 g/dL versus 3.8 +/- 0.37; P <.0001). Delta albumin/treatment inversely correlated with weight loss (r = 0.741, P <.0001) and prescribed ultrafiltration rate (r = 0.764, P <.0001)
  
  
  CONCLUSIONS
  Serum albumin levels increase significantly postdialysis and inversely correlate with fluid removal. Pre-HD albumin level may not be a valid indicator of protein status because of the confounding effect of interdialytic weight gain, and may instead be a marker for fluid overload. Further studies are needed to assess the value of postdialysis albumin level as an indicator of nutritional status in pediatric HD patients.
authors.affiliation: Department of Clinical Nutrition, Stanford University Medical Center, Stanford, CA, USA. twapensky@stanfordmed.org
authors.forename: Tanya
authors.initials: T
authors.lastname: Wapensky
authors.forename: Steven R
authors.initials: SR
authors.lastname: Alexander
authors.forename: Minnie
authors.initials: M
authors.lastname: Sarwal
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D008297:Male; D009748:Nutrition Disorders / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects; D012709:Serum Albumin / Q000032:analysis*; D013997:Time Factors; D015431:Weight Loss / Q000502:physiology
chemical_list: D012709:Serum Albumin