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Influential factors on serum albumin concentration in hospitalized chronic kidney disease patients
Sakiya Yoshimoto1, Kojiro Nagai, Eriko Shibata
1Department of Nephrology, Institute of Biomedical Sciences, Tokushima University Graduate School.
Insights
Serum albumin concentration (SAC) in chronic kidney disease (CKD) patients fluctuates due to factors beyond proteinuria, including posture and diet. Standardizing conditions during blood draws is crucial for accurate SAC analysis in CKD patients.
Area of Science:
- Nephrology
- Clinical Chemistry
Background:
- Serum albumin concentration (SAC) is a prognostic indicator influenced by various physiological and lifestyle factors.
- Chronic kidney disease (CKD) patients present unique challenges affecting SAC, including proteinuria, dietary restrictions, and medication use.
- The specific factors influencing SAC in CKD patients remain incompletely understood.
Purpose of the Study:
- To investigate the influential factors on serum albumin concentration (SAC) in hospitalized patients with chronic kidney disease (CKD).
- To evaluate the impact of proteinuria, glucocorticoid therapy, and hospitalization on SAC dynamics in CKD patients.
Main Methods:
- A retrospective study analyzing hospitalized CKD patients across three groups based on proteinuria levels and glucocorticoid therapy.
- Collected data included SAC, hemoglobin, proteinuria, and blood pressure at multiple time points: pre-hospitalization, during hospitalization, pre-discharge, and post-discharge follow-up.
- Statistical analysis was performed to assess changes in SAC and their correlation with various clinical parameters.
Main Results:
- Serum albumin concentration (SAC) significantly decreased upon hospitalization and subsequently increased at the first outpatient follow-up across all patient groups.
- The observed changes in SAC were found to be independent of the amount of proteinuria.
- Other factors such as postural changes, physical activity, and food intake were identified as potential influencers of SAC.
Conclusions:
- Serum albumin concentration (SAC) in CKD patients is influenced by a complex interplay of factors including proteinuria, postural changes, physical activity, and diet.
- Accurate assessment of SAC in CKD patients necessitates standardization of patient conditions, particularly during blood collection (phlebotomy).
- Further research may be warranted to elucidate the precise mechanisms and relative contributions of these factors to SAC variability in CKD.
Background:
Serum albumin concentration (SAC) is a prognostic factor that is affected by many factors such as postural change, liver function and food intake. Chronic kidney disease (CKD) patients excrete proteinuria, have low-protein diet, and receive glucocorticoid therapy. No one has evaluated the most influential factors on SAC in CKD patients.
Methods:
A retrospective study. Hospitalized CKD patients with less than 1 g/gCreatinine proteinuria receiving glucocorticoid therapy (n=28), with 1 or more g/gCreatinine proteinuria not receiving glucocorticoid therapy (n=36), and with 1 or more g/gCreatinine proteinuria receiving glucocorticoid therapy (n=39) were enrolled. SAC, hemoglobin, proteinuria and blood pressure at the last outpatient check-up before hospitalization, on the second day of hospitalization, at the last laboratory examination before discharge, as well as at the first outpatient follow-up after discharge were analyzed.
Results:
SAC decreased on the second day of hospitalization and increased at the first outpatient follow-up significantly in all groups. Unexpectedly, the change of SAC was irrelevant to the amount of proteinuria.
Conclusions:
SAC was affected by not only proteinuria, but also postural change, physical activity, and food in CKD patients. SAC should be analyzed by standardizing a patient's condition during phlebotomy. J. Med. Invest. 64: 146-152, February, 2017.