Reassessment of albumin as a nutritional marker in kidney disease

Allon N. Friedman, Stephen Z. Fadem

Research output: Contribution to journalReview article

196 Citations (Scopus)

Abstract

The decision by nephrologists, renal dietitians, federal agencies, health care payers, large dialysis organizations, and the research community to embrace serum albumin as an important index of nutrition and clinical performance is based on numerous misconceptions. Patients with analbuminemia are not malnourished and individuals with simple malnutrition are rarely hypoalbuminemic. With the possible exception of kwashiorkor, a rare nutritional state, serum albumin is an unreliable marker of nutritional status. Furthermore, nutritional supplementation has not been clearly shown to raise levels of serum albumin. The use of serum albumin as a quality care index is also problematic. It has encouraged a reflexive reliance on expensive and unproven interventions such as dietary supplements and may lead to adverse selection of healthier patients by health care providers. The authors offer a rationale for considering albumin as a marker of illness rather than nutrition. Viewed in this manner, hypoalbuminemia may offer an opportunity to improve patient well-being by identifying and treating the underlying disorder.

Original languageEnglish (US)
Pages (from-to)223-230
Number of pages8
JournalJournal of the American Society of Nephrology
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2010

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Kidney Diseases
Serum Albumin
Albumins
Kwashiorkor
Hypoalbuminemia
Nutrition Assessment
Nutritionists
Quality of Health Care
Dietary Supplements
Nutritional Status
Malnutrition
Health Personnel
Dialysis
Patient Care
Organizations
Delivery of Health Care
Kidney
Research

ASJC Scopus subject areas

  • Nephrology

Cite this

Reassessment of albumin as a nutritional marker in kidney disease. / Friedman, Allon N.; Fadem, Stephen Z.

In: Journal of the American Society of Nephrology, Vol. 21, No. 2, 01.02.2010, p. 223-230.

Research output: Contribution to journalReview article

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