Analysis of the Factors Determining the Changes of Serum Albumin in Stable Patients on Peritoneal Dialysis.
- Author:
Jong Won PARK
1
;
Dong Hwan KIM
;
Jun Hyuk CHOI
;
Jung Mi KIM
;
Kyu Hyang CHO
;
Jun Young DO
;
Kyung Woo YOON
Author Information
1. Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea. stigmata00@hanmail.net
- Publication Type:Original Article
- Keywords:
Albumin;
Peritoneal transporter;
Peritoneal dialysis
- MeSH:
Creatinine;
Dialysis;
Humans;
Hypoalbuminemia;
Peritoneal Dialysis*;
Risk Factors;
Serum Albumin*;
Urea
- From:Korean Journal of Nephrology
2002;21(4):659-666
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Hypoalbuminemia is the most important risk factor for death in dialysis patients. But, it is not well known the factors determining the changes of serum albumin with time. The present study attempts to address the changes of serum albumin with time and the factors determining the changes of serum albumin in stable patients on peritoneal dialysis. METHODS: Fifty-four peritoneal dialysis patients in stable condition were included. Serum albumin, peritoneal equilibration test, weekly urea clearance (Kt/V), weekly creatinine clearance(CCr) and normalized protein catabolic rate(nPCR) were determined two times(mean 5.8+/-2.3 months and 31.3+/-6.5 months after initiation of peritoneal dialysis). RESULTS: Initially lower serum albumin group patients(below 3.7 g/dL) showed significantly increased serum albumin level with time(3.2+/-0.43 g/dL vs 3.57+/-0.52 g/dL, p=0.006) and initially higher serum albumin group patients(above 3.7 g/dL) showed decreased serum albumin level with time(4.07+/-0.32 g/dL vs 3.97+/-0.3 g/dL, p=0.15). Serum albumin changes(delta) were significantly higher in initially lower serum albumin group than higher serum albumin group(0.37+/-0.6 g/dL vs -0.11+/-0.3 g/dL, p < 0.01). There were negative correlations between delta serum albumin and delta D/PCr with time in initially lower and initially higher serum albumin groups(0.37+/-0.56 g/dL vs -0.02+/-0.11, -0.11+/-0.33 g/dL vs 0.05+/-0.12, respectively, r=-0.308, p=0.008). The group which increased serum albumin level with time showed significantly lower initial serum albumin(3.32+/-0.51 g/dL vs 3.98+/-0.46 g/dL, p < 0.001) and significantly decreased D/P(Cr) changes(-0.03+/-0.09 vs 0.06+/-0.10, p= 0.02) than the group which decreased serum albumin level with time. With multiple regression analysis, initial serum albumin level and the change of D/P(Cr) were significant predictors of the change of serum albumin with time. CONCLUSION: Initial serum albumin and the change of D/PCr were identified as the predictors of the change of serum albumin in stable peritoneal dialysis patients.
