Regulation of Albumin Metabolism

Rothschild, Marcus A.; Oratz, Murray; Schreiber, S. S.

doi:10.1146/annurev.me.26.020175.000515

Cited by 48 publications

(29 citation statements)

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“…Also limiting the usefulness of serum albumin as a nutritional marker are counter-regulatory mechanisms. In the short term, protein deficiency decreases the rate of albumin synthesis (5), but over time compensation occurs through a decrease in albumin breakdown and a shift of albumin from the extravascular to the intravascular space.…”

Section: Introductionmentioning

confidence: 99%

Serum Albumin as Predictor of Nutritional Status in Patients with ESRD

Gama-Axelsson

Heimbürger

Stenvinkel

et al. 2012

Clinical Journal of the American Society of Nephrology

164

101

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SummaryBackground and objectives Serum albumin is a widely used biomarker of nutritional status in patients with CKD; however, its usefulness is debated. This study investigated serum albumin and its correlation with several markers of nutritional status in incident and prevalent dialysis patients.Design, setting, participants, & measurements In a cross-sectional study, serum albumin (bromocresol purple), and other biochemical (serum creatinine), clinical (subjective global assessment [SGA]), anthropometric (handgrip strength; skinfold thicknesses), and densitometry (dual-energy x-ray absorptiometry) markers of nutritional status were assessed in 458 incident (61% male; mean age, 54613 years; GFR, 6.660.3 ml/min per 1.73 m 2 ; recruited 1994-2010) and 383 prevalent (56% male; mean age, 62614 years; recruited 1989-2004) dialysis patients. ResultsIn incident patients, serum albumin was correlated with age (b =20.15; P,0.001), diabetes (b=20.30; P,0.001), high-sensitivity C-reactive protein (b =20.37; P,0.001), and urinary albumin excretion (b=20.38; P,0.001) but less so with poor nutritional status (SGA score . 1; b=20.19; P,0.001). In prevalent patients, serum albumin was correlated with age (b=20.15; P,0.001), high-sensitivity C-reactive protein (b=20.30; P,0.001), diabetes (b=20.31; P,0.001), and SGA score . 1 (b=20.16; P,0.001). In predicting nutritional status assessed by SGA and other markers, adding serum albumin to models that included age, sex, diabetes, and cardiovascular disease did not significantly increase explanatory power.Conclusions In incident and prevalent dialysis patients, serum albumin correlates poorly with several markers of nutritional status. Thus, its value as a reliable marker of nutritional status in patients with ESRD is limited.

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Section: Introductionmentioning

confidence: 99%

Serum Albumin as Predictor of Nutritional Status in Patients with ESRD

Gama-Axelsson

Heimbürger

Stenvinkel

et al. 2012

Clinical Journal of the American Society of Nephrology

164

101

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“…5 Reduced protein consumption slows mRNA synthesis of albumin and results in lower serum levels, 3,6 -11 although only in the setting of negligible dietary protein intake. Protein restriction also slows albumin degradation, although to a lesser degree than reductions in the synthesis rate.…”

Section: General Populationmentioning

confidence: 99%

Reassessment of Albumin as a Nutritional Marker in Kidney Disease

Friedman¹,

Fadem

2010

Journal of the American Society of Nephrology

315

245

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“…Albumin is synthesized in the liver and has a variety of functions, including the maintenance of oncotic pressure and transport of molecules and drugs 10,15,16 .…”

Section: Determinants Of Serum Albuminmentioning

confidence: 99%

Malnutrition in the ICU: Current recommendations for the assessment of nutritional status and a review of the use of albumin as an indicator of malnutrition

Fuhrmann

Panamonta²,

Roaten³

2013

SW Resp Crit Care Chron

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CasePatient X is a 55-year-old man, 72 inches tall, weighing 86 kg, status post motor vehicle accident with multisystem trauma. The patient is currently receiving sedation, pain control, and maintenance IV fluids; he received 3 liters of NS bolus, 2 units of FFP, and 2 units of PRBCs on admission. On admission, labs included CRP -2.1mg/dL, Alb -4.5 gm/dL and transthyretin (TTR, prealbumin) -17mg/dL. Labs on day three showed that the CRP was 37 mg/dL, Alb 1.2 gm/dL, and transthyretin 10 mg/dL. In an overall assessment of the patient, the clinician states that based on the most recent labs, enteral or parenteral nutrition needs to be started due to malnutrition as indicated by his low albumin. DisCussion Malnutrition in the iCuMalnutrition is very common in critically ill patients, and its development is a function of the patients' preexisting nutritional status and severity of illness (degree of hypermetabolism). The characteristics of ICU patients have changed during the last decade; they now tend to be older and their medical disorders more complex with frequent comorbidity. These factors may contribute to malnutrition in the ICU. The combination of stress and undernutrition is associated with negative energy balances and the loss of lean body mass 1 . Critically ill patients often have a history of decreased food intake from anorexia, gastrointestinal symptoms, depression, anxiety, and other medical and surgical factors on presentation. Their food intake may have also been restricted for diagnostic or therapeutic procedures during hospital stay, and they may have nutrient loss from diarrhea, vomiting, polyuria, wounds, drainage tubes, and renal replacement therapy 2,3 .The major physiologic change

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Regulation of Albumin Metabolism

Cited by 48 publications

References 0 publications

Serum Albumin as Predictor of Nutritional Status in Patients with ESRD

Serum Albumin as Predictor of Nutritional Status in Patients with ESRD

Reassessment of Albumin as a Nutritional Marker in Kidney Disease

Malnutrition in the ICU: Current recommendations for the assessment of nutritional status and a review of the use of albumin as an indicator of malnutrition

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