MODEST REDUCTION OF SERUM-ALBUMIN IN CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS PATIENTS IS COMMON AND OF NO APPARENT CLINICAL CONSEQUENCE

It is commonly assumed that a reduction in serum albumin is a reliable sign of nutritional inadequacy affecting prognosis in continuous ambulatory peritoneal dialysis (CAPD) patients. We studied prospectively 19 patients starting CAPD and monitored them for a minimum of 15 months. Serum albumin, changes in dry weight, morbid events, and, where possible, protein catabolic rates (PCR) and urea nitrogen appearance (UNA) were determined. A modest reduction in serum albumin (25 to 33 g/L [2.5 to 3.3 g/dL]) was found in the majority of patients 3 months after starting CAPD, which persisted for 12 months. Most of these patients gained weight and were not hospitalized in that period. PCR and UNA values showed adequate nutrition. Two patients developed serious medical problems leading to clinical malnutrition and serum albumin rapidly falling below 20 g/L. A modest reduction in serum albumin (25 to 33 g/L) is common in healthy CAPD patients and, if stable, does not indicate a poor prognosis or nutritional inadequacy. © 1992, National Kidney Foundation. All rights reserved. All rights reserved.