scholarly journals The Effect of Acidosis on Albumin Level in Patients Treated With Regular Hemodialysis (Single Center Study)

2018 ◽  
Vol 10 (11) ◽  
pp. 57
Author(s):  
Manal Khudder Abdul Razak ◽  
Jawad Ibrahim Rasheed ◽  
Mudhafar Mohammed Meizel
Keyword(s):  
Metabolic Acidosis ◽  
Renal Disease ◽  
Serum Albumin ◽  
End Stage Renal Disease ◽  
Albumin Level ◽  
Albumin Concentration ◽  
Serum Albumin Concentration ◽  
Serum Bicarbonate ◽  
Stage Renal Disease ◽  
End Stage

BACKGROUND: Hypoalbuminemia is the most powerful predictor of mortality in end-stage renal disease on hemodialysis. Metabolic acidosis induces net negative nitrogen and total body protein balance. Some patients undergoing maintenance dialysis have low plasma bicarbonate levels due to inadequate dialysis. We aimed to evaluate the role of metabolic acidosis on serum albumin concentration in patients with end stage renal disease on hemodialysis, and to determine differences of serum bicarbonate level before and after hemodialysis in actual situation. METHODS: This cross sectional comparative study was conducted in the Iraqi Center for Hemodialysis/ Baghdad Teaching Hospital from June to December 2015. It included 100 subjects with end stage renal disease on hemodialysis. They were divided equally into cases with low albumin and comparison group with normal albumin level. Serum bicarbonate and the Kt/V were measured for all subjects before, after, and before next hemodialysis session to show the adequacy of dialysis. RESULTS: There was a significant association between low bicarbonate and low albumin level in hemodialysis patient and between numbers and duration of dialysis session with albumin. Low Kt/V was significantly associated with hypoalbuminemia. There was no statistically significant association between age and gender with hypoalbuminemia. CONCLUSION: This study shows that patients with metabolic acidosis had a lower serum albumin concentration and there was a significant correlation between numbers, duration and adequacy of hemodialysis sessions and albumin level. We recommend to increase the numbers of dialysis centers in Iraq and adjust the bicarbonate doses in dialysate according to patient’s bicarbonate levels.

scholarly journals Serum albumin concentration and risk of end-stage renal disease: the REGARDS study

2017 ◽  
Vol 33 (10) ◽  
pp. 1770-1777 ◽  
Author(s):  
Carl P Walther ◽  
Orlando M Gutiérrez ◽  
Mary Cushman ◽  
Suzanne E Judd ◽  
Joshua Lang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Disease ◽  
Serum Albumin ◽  
End Stage Renal Disease ◽  
Albumin Concentration ◽  
Serum Albumin Concentration ◽  
Lower Serum ◽  
Regards Study ◽  
Stage Renal Disease ◽  
End Stage

ABSTRACT Background Serum albumin concentration is a commonly available biomarker with prognostic value in many disease states. It is uncertain whether serum albumin concentrations are associated with incident end-stage renal disease (ESRD) independently of urine albumin-to-creatinine ratio (ACR). Methods A longitudinal evaluation was performed of a population-based community-living cohort from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Participants were ≥45 years of age at study entry and had serum albumin, creatinine, cystatin C and spot urine ACR measured at the baseline visit (n = 19 633). Estimated glomerular filtration rate (eGFR) was from the Chronic Kidney Disease Epidemiology Collaboration combined creatinine-cystatin C equation. Baseline serum albumin concentration was the predictor variable, and hazard ratios (HRs) for incident ESRD (from US Renal Data System linkage) were calculated in sequentially adjusted models. Results Age at study entry was 63.9 ± 9.7 years, 62% of the participants were female and 40% were black. Mean eGFR at baseline was 83.3 ± 20.8 mL/min/1.73 m2. Over a median 8-year follow-up, 1.2% (n = 236) developed ESRD. In models adjusted for baseline eGFR, ACR and other ESRD risk factors, the HR for incident ESRD was 1.16 [95% confidence interval (CI) 1.01–1.33] for each standard deviation (0.33 g/dL) lower serum albumin concentration. The HR comparing the lowest (<4 g/dL) and highest quartiles (≥4.4 g/dL) of serum albumin was 1.61 (95% CI 0.98–2.63). Results were qualitatively similar among participants with eGFR <60 and ≥60 mL/min/1.73 m2, and those with and without diabetes. Conclusions In community-dwelling US adults, lower serum albumin concentration is associated with higher risk of incident ESRD independently of baseline urine ACR, eGFR and other ESRD risk factors.

Serum albumin, inflammation, and nutrition in end-stage renal disease: C-reactive protein is needed for optimal assessment

2018 ◽  
Vol 31 (5) ◽  
pp. 435-439 ◽  
Author(s):  
Hideyuki Mukai ◽  
Hilda Villafuerte ◽  
Abdul Rashid Qureshi ◽  
Bengt Lindholm ◽  
Peter Stenvinkel
Keyword(s):  
Renal Disease ◽  
Serum Albumin ◽  
End Stage Renal Disease ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Serum albumin fragmentation in end-stage renal disease patients – a pilot study

2009 ◽  
Vol 47 (11) ◽  
Author(s):  
Elena Donadio ◽  
Francesco Piccolomini ◽  
Veronica Dimuccio ◽  
Antonio Felicioli ◽  
Ettore Balestreri ◽  
...  
Keyword(s):  
Pilot Study ◽  
Renal Disease ◽  
Serum Albumin ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

End-Stage Renal Disease Patients with Low Serum Albumin: Is Peritoneal Dialysis an Option?

2019 ◽  
Vol 39 (6) ◽  
pp. 562-567 ◽  
Author(s):  
Tripti Singh ◽  
Brad C. Astor ◽  
Sana Waheed
Keyword(s):  
Peritoneal Dialysis ◽  
Renal Disease ◽  
Serum Albumin ◽  
End Stage Renal Disease ◽  
Chronic Dialysis ◽  
Lower Mortality ◽  
Dialysis Modality ◽  
Stage Renal Disease ◽  
End Stage ◽  
Low Serum

Introduction Low serum albumin is associated with high mortality in patients with end-stage renal disease (ESRD) on chronic dialysis. Clinicians are reluctant to offer peritoneal dialysis (PD) as an option for dialysis for patients with low serum albumin due to concerns of loss of albumin with PD, but evidence supporting differences in outcomes is limited. We evaluated mortality based on dialysis modality in patients with very low serum albumin (< 2.5 g/dL). Methods We analyzed United States Renal Data System (USRDS) data from 2010 to 2015 to assess mortality by modality adjusted for age, sex, race, employment, number of comorbidities, and year of dialysis initiation. Results Low serum albumin (< 2.5 g/dL) was present in 78,625 (19.9%) of 395,656 patients with ESRD on chronic dialysis. Patients with low serum albumin were less likely to use PD as their first modality than those with higher albumin (3.1% vs 10.9%; p < 0.001). Use of PD was associated with lower mortality compared with hemodialysis (HD) (hazard ratio [HR] = 0.88, 95% confidence interval [CI] 0.81 – 0.95, p < 0.05) in patients with low serum albumin. This difference was more pronounced in patients who had glomerulonephritis (HR = 0.72) or hypertension (HR = 0.81) than in those with end-stage renal disease (ESRD) due to diabetes mellitus or other causes. Conclusion Peritoneal dialysis is less likely to be the first dialysis modality in patients with low serum albumin requiring dialysis. However, PD is associated with lower mortality than HD in patients with low serum albumin on dialysis. We recommend advocating the use of PD in patients with low serum albumin.

Reviews and Original Articles Lipoprotein(A) and Apolipoprotein(A) Phenotypes in Patients with End-Stage Renal Disease

1997 ◽  
Vol 17 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Soon Bae Kim ◽  
Won Seok Yang ◽  
Eun Suk Kang ◽  
Won Ki Min ◽  
Jung Sik Park
Keyword(s):  
Molecular Weight ◽  
Renal Disease ◽  
Serum Albumin ◽  
High Molecular Weight ◽  
End Stage Renal Disease ◽  
Lipoprotein A ◽  
Apolipoprotein A ◽  
Significant Difference ◽  
Stage Renal Disease ◽  
End Stage

Objective To evaluate the distribution pattern of apolipoprotein(a) [Apo(a)] phenotypes in Koreans and the effect of dialysis modality on serum lipoprotein(a) [Lp(a)] concentration according to apo(a) phenotype in patients with end-stage renal disease (ESRO). Design Cross-sectional study. Setting A university hospital. Participants: 153 normal controls, 99 hemodialysis (HO) patients and 82 continuous ambulatory peritoneal dialysis (CAPO) patients. Main Outcome Measures Fasting serum Lp(a), lipids, and apo(a) phenotypes were measured. Results The frequencies of the subjects with apo(a) phenotypes of high-molecular weight only, including S3, S4, or S5 or null type were 95.4% of control, 100% of HO patients, and 95.1% of CAPO patients. The frequent apo(a) phenotypes in Koreans consisted of S4, S4S5, S5, and S5S5 isoforms. Significant difference was found in serum Lp(a) concentration among controls and HO and CAPO patients [median (interquartile range): 0.05 g/L, (0.01 0.19); 0.19g/L, (0.10 0.35); 0.63g/L, (0.28 0.90), p< 0.001]. Lp(a) levels in CAPO patients were significantly higher than in HO patients for all four common apo(a) isoforms found in Korean subjects. CAPO patients had higher total and LOL cholesterol levels, and higher ApoB levels than H O patients. Significant differences were found in serum albumin levels between controls and HO and CAPO patients (44 ± 3 g/L, 40 ± 4 g/L, 32 ± 7 g/L, respectively, p < 0.05). There were significant inverse correlations between serum albumin and Lp(a) (r = -0.33, p < 0.01), total cholesterol (r = -0.31, p < 0.01), LOL (r = -0.39, p < 0.01) or ApoB (r = -0.35, p < 0.01) in ESRO patients. A significant positive correlation was found between serum albumin and ApoA1 (r = 0.24, p < 0.01). Conclusion These findings indicate that Koreans have mainly high -molecular weight apo(a) phenotypes and serum Lp(a) is elevated in CAPO patients compared to HO patients for common apo(a) phenotypes, which may contribute to the frequent cardiovascular mortality in CAPO patients.

Lentiform fork sign in a case with end-stage renal disease and metabolic acidosis

2014 ◽  
Vol 115 (3) ◽  
pp. 411-413
Author(s):  
Eda Derle ◽  
Seda Kibaroglu ◽  
Pınar Cınar ◽  
Ruhsen Öcal ◽  
Ufuk Can
Keyword(s):  
Metabolic Acidosis ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage
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