       Document 0299
 DOCN  M9610299
 TI    Mechanisms of hypoalbuminemia in hemodialysis patients.
 DT    9601
 AU    Kaysen GA; Rathore V; Shearer GC; Depner TA; Department of Medicine,
       University of California at Davis, School; of Medicine, USA.
 SO    Kidney Int. 1995 Aug;48(2):510-6. Unique Identifier : AIDSLINE
       MED/96047726
 AB    Hypoalbuminemia is the most powerful predictor of mortality in end-stage
       renal disease. Since protein-calorie malnutrition can decrease albumin
       synthesis it is assumed that hypoalbuminemia results principally from
       malnutrition in these patients, but albumin synthesis may also be
       decreased as part of the acute-phase response, and hypoalbuminemia can
       also result from redistribution of albumin pools or from albumin losses.
       We measured albumin synthesis, fractional catabolic rate, and
       distribution from the turnover of [125I] human albumin in six
       hemodialysis patients with plasma albumin less than 35 mg/ml and in six
       patients with plasma albumin greater than 40 mg/ml. Patients with liver
       disease, HIV, or other infection were excluded. Both groups were
       maintained with high-flux polysulfone dialyzers for more than three
       months. Kt/Vurea and PCR were measured during each dialysis (N = 12 to
       18/patient). A four-day calorie and protein intake was determined by
       dietary history and long-term nutritional status was determined
       anthropometrically. Measured variables included serum urea, creatinine,
       transferrin, and the positive acute-phase proteins alpha 2-
       macroglobulin, C-reactive protein, ferritin, and IGF-1. Albumin
       synthesis was significantly reduced in the low albumin group. There were
       no differences in dietary intake, body composition, PCR, BUN,
       creatinine, or Kt/Vurea. Plasma albumin concentration correlated
       negatively with ferritin, C-reactive protein and alpha 2-macroglobulin.
       Albumin synthesis rate correlated negatively with both alpha
       2-macroglobulin and Kt/Vurea. Both plasma albumin concentration and
       synthesis rate correlated positively with IGF-1, and both were
       independent of PCR and all other nutrition-related variables.(ABSTRACT
       TRUNCATED AT 250 WORDS)
 DE    Acute-Phase Proteins/METABOLISM  Aged  Aged, 80 and over  Biomechanics
       Blood/METABOLISM  Female  *Hemodialysis  Human  Male  Middle Age
       Nutritional Status  Osmolar Concentration  Serum Albumin/*METABOLISM
       Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

