Serum albumin: associations and significance in peritoneal dialysis

Hypoalbuminemia in hemodialysis patients is a strong predictor of mortality; however, the significance of hypoalbuminemia in peritoneal dialysis patients is less well-defined. We have analyzed the factors associated with hypoalbuminemia in a cross-sectional study of 36 peritoneal dialysis patients, and investigated the impact of hypoalbuminemia on the one-year clinical outcome in 53 peritoneal dialysis patients. We found hypoalbuminemia to be associated with low values for the kinetic parameters KT/V, creatinine clearance, and normalized protein catabolic rate (nPCR) by univariant analysis. In a multiple regression model, nPCR was the only significant predictor of serum albumin. Clinical outcome measures evaluated were days-hospitalized, peritonitis rate, and death. Days-hospitalized was inversely correlated with serum albumin, and deaths occurred only in patients with serum albumin less than 4.0 mg/dL. There were no associations with peritonitis episodes. In conclusion, our study provides evidence that hypoalbuminemia in peritoneal dialysis patients is associated with a low protein intake measured by the nPCR and, possibly, with a low delivered dose of dialysis. Our study also suggests that the serum albumin level correlates to clinical outcome measured by days-hospitalized.