Serum albumin, body weight and inflammatory parameters in chronic hemodialysis patients: a three-year longitudinal study.
OBJECTIVE
The present study aimed at making prospective longitudinal measurements of nutritional and inflammatory parameters to determine whether nutritional and inflammatory status decline or increase over time in a cohort of prevalent hemodialysis patients, and to evaluate which factors influence eventual changes.


METHODS
64 hemodialysis patients were followed at 0, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30, 33, and 36 months. At each follow-up visit, dry body weight, serum albumin, serum total cholesterol, total white blood cells, total lymphocyte count, serum glucose, C-reactive protein, ferritin, fibrinogen, hemoglobin, and weekly erythropoietin dose were assessed.


METHODS
Changes in nutritional and inflammatory parameters over time.


RESULTS
43 patients completed the study at 36 months. Mean serum albumin levels (g/dl) improved significantly between baseline (3.76 +/- 0.24) and 36 months (3.93 +/- 0.27) (F = 4.005; p = 0.0009). Dialytic age was significantly associated with changes of serum albumin (F = 2.797; p = 0.028). The mean dry weight slightly remained stable over time (F = 1.473; p = 1.0) as well as the level of total cholesterol (p = 0.77) and lymphocyte count (F = 1.539; p = 0.186). Over time, the levels of C-reactive protein tended to decrease, although the differences were not statistically significant (F = 1.332; p = 0.19). Over time, the serum level of fibrinogen (F = 0.422; p = 0.17) and ferritin (F = 0.314; p = 0.52) remained stable. The number of white blood cells significantly decreased over time (F = 4.691; p = 0.0079) and dialytic age (F = 3.214; p = 0.015) was the variable significantly associated with such decline. The hemoglobin levels (F = 1.423; p = 0.14) and the weekly erythropoietin dose did not change significantly during the study (F = 1.019; p = 0.61), nor did the serum glucose levels (F = 1.231; p = 0.10).


CONCLUSIONS
These results support the hypothesis that end-stage renal disease and HD are not necessarily associated with deterioration of the nutritional status over time.
Bossola
Maurizio
M
Istituto di Clinica Chirurgica, Università Cattolica del Sacro Cuore, Rome, Italy. maubosso@tin.it
La Torre
Giuseppe
G
Giungi
Stefania
S
Tazza
Luigi
L
Vulpio
Carlo
C
Luciani
Giovanna
G
D000368:Aged; D000418:Albumins / Q000378:metabolism*; D001835:Body Weight / Q000502:physiology*; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology*; D008137:Longitudinal Studies; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D011446:Prospective Studies; D013997:Time Factors
D000418:Albumins; D005340:Fibrinogen; D002097:C-Reactive Protein; D005293:Ferritins; D002784:Cholesterol