Acute phase proteins and peritoneal dialysate albumin loss are the main determinants of serum albumin in peritoneal dialysis patients

Am J Kidney Dis. 1997 Dec;30(6):923-7. doi: 10.1016/s0272-6386(97)90105-0.


Hypoalbuminemia predicts mortality in dialysis patients. It has been postulated that hypoalbuminemia in the dialysis population is a consequence of poor protein intake resulting from inadequate dialysis. To establish the cause of hypoalbuminemia in a group of 27 patients on peritoneal dialysis (PD), we determined the relationship between serum albumin concentration and a group of parameters including dialysis dose delivered (Kt/V), normalized protein catabolic rate (PCRn), transperitoneal and urinary albumin losses, and the serum concentration of two acute-phase proteins, C-reactive protein (CRP), and serum amyloid A (SAA). Serum albumin concentration could be predicted by a combination of transperitoneal albumin loss and either the serum concentration of CRP or of SAA. There was no relationship between weekly Kt/V or PCRn and serum albumin concentration. CRP and SAA significantly correlated with one another, but neither correlated with transperitoneal albumin losses. Hypoalbuminemia in PD patients is a consequence of transperitoneal albumin losses and of the acute phase response.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Acute-Phase Reaction / blood
  • Acute-Phase Reaction / urine
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Albumins / analysis*
  • Albuminuria / urine
  • C-Reactive Protein / analysis*
  • Dialysis Solutions / administration & dosage
  • Dialysis Solutions / analysis*
  • Dietary Proteins / administration & dosage
  • Dietary Proteins / metabolism
  • Female
  • Forecasting
  • Humans
  • Male
  • Middle Aged
  • Peritoneal Dialysis*
  • Peritoneum / metabolism
  • Proteins / metabolism
  • Serum Albumin / analysis*
  • Serum Amyloid A Protein / analysis*
  • Survival Rate


  • Albumins
  • Dialysis Solutions
  • Dietary Proteins
  • Proteins
  • Serum Albumin
  • Serum Amyloid A Protein
  • C-Reactive Protein