Determinants of serum albumin concentration analyzed in a large cohort of patients on maintenance hemodialysis.
OBJECTIVE
Serum albumin concentration is a powerful predictor of mortality in patients on chronic hemodialysis (CHD). This study sought to investigate variables associated with serum albumin concentration.


METHODS
Cross-sectional study in prevalent chronic hemodialysis patients treated at the Renal Research Institute between July 1, 2005 and October 31, 2005. A total of 4,798 (2,199 females) patients were studied.


METHODS
Univariate and multivariate relationships of serum albumin concentration with age, sex, race (black, white, other), vascular access type (arteriovenous fistula/graft, catheter), white blood cells, neutrophils, lymphocytes, equilibrated normalized protein catabolic rate (enPCR), dialysis efficacy (eKdrt/V), hemoglobin, phosphate, bio-intact parathyroid hormone [bioPTH], creatinine, alanine aminotransferase (ALT), and aspartate aminotransferase (AST).


RESULTS
Age, access type, and variables of 3 domains, namely, nutrition (enPCR; creatinine), eKdrt/V, and inflammation (white blood cells; neutrophil:lymphocyte ratio; hemoglobin), were related to serum albumin. It is interesting to note that AST was the strongest negative predictor of albumin levels.


CONCLUSIONS
In CHD patients, serum albumin concentration is defined by a complex interaction of inflammation, nutrition, and dialysis efficacy. The relationship between AST and albumin deserves additional study.
Thijssen
Stephan
S
Renal Research Institute, New York, New York 10128, USA.
Wystrychowski
Grzegorz
G
Usvyat
Len
L
Kotanko
Peter
P
Levin
Nathan W
NW
D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis*
D012709:Serum Albumin