Longitudinal Measures of Serum Albumin and Prealbumin Concentrations in Incident Dialysis Patients: The Comprehensive Dialysis Study

Lorien Dalrymple, Kirsten L. Johansen, Glenn M. Chertow, Barbara Grimes, Shuchi Anand, Charles E. McCulloch, George Kaysen

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: Serum albumin and prealbumin concentrations are strongly associated with the risk of death in dialysis patients. Our study examined the association among demographic characteristics, body composition, comorbidities, dialysis modality and access, inflammation, and longitudinal measures of albumin and prealbumin concentrations in incident dialysis patients. Design, Setting, Subjects, and Outcome Measures: The Comprehensive Dialysis Study is a prospective cohort study of incident dialysis patients; in this report, we examined the data from 266 Nutrition substudy participants who donated serum. The independent variables of interest were baseline age, sex, race, Quetélet's (body mass) index, dialysis modality and access, diabetes, heart failure, atherosclerotic vascular disease, serum creatinine level, and longitudinal measures of C-reactive protein. The outcomes of interest (dependent variables) were longitudinal measures of albumin and prealbumin concentrations, recorded at study entry and thereafter every 3 months for 1 year. Results: In multivariable mixed linear models, female sex, peritoneal dialysis, hemodialysis with a catheter, and higher C-reactive protein concentrations were associated with lower serum albumin concentrations, and serum albumin concentrations increased slightly over the year. In comparison, prealbumin concentrations did not significantly change over time; female sex, lower body mass index, diabetes, atherosclerotic vascular disease, and higher C-reactive protein concentrations were associated with lower prealbumin concentrations. Serum creatinine had a curvilinear relation with serum albumin and prealbumin. Conclusions: Serum albumin level increases early in the course of dialysis, whereas prealbumin level does not, and the predictors of serum concentrations differ at any given time. Further understanding of the mechanisms underlying differences between albumin and prealbumin kinetics in dialysis patients may lead to an improved approach to the management of protein-energy wasting.

Original languageEnglish (US)
Pages (from-to)91-97
Number of pages7
JournalJournal of Renal Nutrition
Volume23
Issue number2
DOIs
StatePublished - Mar 2013

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Prealbumin
Serum Albumin
Dialysis
C-Reactive Protein
Albumins
Serum
Vascular Diseases
Creatinine
Body Mass Index
Peritoneal Dialysis
Body Composition
Renal Dialysis
Comorbidity
Linear Models
Cohort Studies
Catheters
Heart Failure
Demography
Outcome Assessment (Health Care)
Prospective Studies

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Nephrology

Cite this

Longitudinal Measures of Serum Albumin and Prealbumin Concentrations in Incident Dialysis Patients : The Comprehensive Dialysis Study. / Dalrymple, Lorien; Johansen, Kirsten L.; Chertow, Glenn M.; Grimes, Barbara; Anand, Shuchi; McCulloch, Charles E.; Kaysen, George.

In: Journal of Renal Nutrition, Vol. 23, No. 2, 03.2013, p. 91-97.

Research output: Contribution to journalArticle

Dalrymple, Lorien ; Johansen, Kirsten L. ; Chertow, Glenn M. ; Grimes, Barbara ; Anand, Shuchi ; McCulloch, Charles E. ; Kaysen, George. / Longitudinal Measures of Serum Albumin and Prealbumin Concentrations in Incident Dialysis Patients : The Comprehensive Dialysis Study. In: Journal of Renal Nutrition. 2013 ; Vol. 23, No. 2. pp. 91-97.
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