Nephrology Dialysis Transplantation, Vol 12, Issue 7 1406-1413, Copyright © 1997 by Oxford University Press
CH Jones, CG Newstead, EJ Will, SW Smye and AM Davison
INTRODUCTION: In CAPD patients serum albumin is frequently used as an index
of nutritional status, although it is recognized that hypoalbuminaemia may
be caused by many factors. We have further examined the relationship
between serum albumin and nutrition. METHODS: Nutritional status was
assessed by biochemistry, anthropometry, mid-arm muscle circumference,
muscle strength (hand grip and back), and lean body mass (from
anthropometry, creatinine kinetics and bioimpedance) in a group of 76
stable CAPD patients. Correlations between biochemical and nutritional
parameters were sought and data were compared between patient groups
defined by serum albumin (> or = 37 vs < 37 g/l on two occasions 2
months apart) and separately according to subjective global assessment
score (normal nutrition, A vs mild to moderate, B, and severe, C,
malnutrition). RESULTS: In patients with a low SGA score, actual body
weight, body mass index, mid-arm muscle circumference, lean body mass,
subscapular skinfold thickness, hand grip strength (males and females) and
iliac and triceps skinfold thicknesses and back strength (females only)
were all significantly less than in patients with a normal SGA score. In
contrast, none of these variables differed in either gender when patients
were compared according to serum albumin. Serum albumin was correlated with
serum creatinine (r = 0.45, P = 0.01), daily urine protein excretion (r =
-0.42, P = 0.02) and uncorrected weekly creatinine clearance (r = -0.39) in
females, but not with any index of body composition in either gender.
CONCLUSION: Whilst SGA identified a patient group with significantly
abnormal body mass, muscle mass and muscle strength, serum albumin did not.
Serum albumin is not a useful marker of malnutrition in stable patients on
CAPD.
ORIGINAL ARTICLES
Assessment of nutritional status in CAPD patients: serum albumin is not a useful measure
Department of Renal Medicine, St James's University Hospital, Leeds, UK.
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