Authors: Youngmee Kim Miklos Z Molnar Manoch Rattanasompattikul Parta Hatamizadeh Debbie Benner Joel D Kopple Csaba P Kovesdy Kamyar KalantarZadeh
Publish Date: 2012/04/15
Volume: 45, Issue: 1, Pages: 215-227
Abstract
Serum albumin is one of the strongest mortality predictors in maintenance hemodialysis MHD patients Yet the degree to which serum albumin represents dietary protein intake or an inflammatory state among others is not clear We hypothesize that these inadequate protein intake and inflammation contribute somewhat equally to hypoalbuminemiaIn a crosssectional analysis we examined correlates of low serum albumin 38 g/dL in 812 MHD patients in whom interleukin6 IL6 and normalized protein nitrogen appearance nPNA also known as normalized protein catabolic rate nPCR were also measured Logistic regression estimated odds ratios were employed and spline models were plotted to examine the likelihood of relatively low serum albumin 38 g/dLMean age ±SD of patients was 54 ± 15 years 53 of patients were men 50 Hispanic 31 African–American and 55 diabetic The mean dialysis vintage was 31 ± 34 months median 19 interquartile range 7–44 months The baseline serum albumin averaged over a 3month period mean ± SD was 388 ± 038 g/mL The unadjusted correlation coefficients of l IL6 and nPNA with serum albumin were −036 and +020 respectively p 0001 for each comparison The likelihood for an albumin 38 gr/dL increased linearly with decreasing nPNA and rising serum IL6 This trend was steeper with increasing serum IL6 up to a concentration of 30 ng/mLThe authors are thankful to Ms Stephanie Griffith and Dr Victor Goh at HarborUCLA GCRC Core Laboratories for the management of blood samples and measuring inflammatory markers This study was supported by a research grant from the National Institutes of Health National Institute of Diabetes Digestive and Kidney Disease grant DK61162 for KKZ a research grant from DaVita Inc KKZ and a General Clinical Research Center GCRC grant M01RR00425 from the National Centers for Research Resources National Institutes of Health MZM received the grants from the National Developmental Agency KTIAOTKAEU 7KPHUMANMB08A81231 from the Research and Technological Innovation Fund and is recipient of the Hungarian Eötvös Scholarship MÖB/772/2012
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