Rise in serum albumin and creatinine in the first half year on hemodialysis

Abstract

Serum albumin and creatinine rose by 12 to 13% during the first half year of hemodialysis in a stable cohort. The slope of serum albumin versus time predicted survival, but it was not as predictive as the absolute albumin concentration. The pattern of correlations of baseline urinary protein and creatinine excretion with the respective monthly serum values of albumin and creatinine and their slopes is consistent with the hypothesis that as residual renal function declines, progressive retention of protein and creatinine contributes to the respective rises in serum albumin and creatinine.

Frailty and Protein-Energy Wasting in Elderly Patients with End Stage Kidney Disease

“…15,171,172 Indeed, commencement of dialysis is often associated with improvement in protein-energy status. 173,174 Better control of uremia may lead to less frailty and PEW. Experience with quotidian hemodialysis suggests that more than two times per week MHD treatments and larger doses of dialysis may improve patients' appetite, food intake, nutritional status, and QOL and reduce frailty and PEW.…”

Cross-sectional and longitudinal predictors of serum albumin in hemodialysis patients

“…A lower albumin concentration is predictors of trends in serum albumin in survivors only (that is, excluding those who because of death during expected in new dialysis patients because of a combination of poor nutrition, dilutional effects, and residual the period follow-up could not contribute data on late follow-up serum albumin measurements). proteinuria [7,9,32]. The survivor-only sensitivity analysis in this study and the analyses of previous studies [9] Many of the exposures examined, such as demographics and comorbidity variables, may not be modifiable.…”

Opponent’s comments

“…In our experience and in the published literature, weight loss and PEW are particularly common when GFR decreases to <10-15 mL/min/1.73 m 2 in CKD and during the months before they begin chronic dialysis therapy [7][8][9]. Once patients commence chronic dialysis there may be some improvement in their protein-energy status, but PEW remains common in these patients [10][11][12]. Advanced CKD patients with PEW have both reduced quality of life and increased mortality rates [13,14].…”