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Normalized protein catabolic rate versus serum albumin as a nutrition status marker in pediatric patients receiving hemodialysis.
J Ren Nutr. 2007 Jul; 17(4):269-74.JR

Abstract

BACKGROUND

Protein-energy malnutrition occurs commonly in patients receiving hemodialysis (HD). Although serum albumin (sAlb) is recommended to monitor nutrition status in patients receiving HD, many processes unrelated to nutrition status can affect albumin concentrations.

METHODS

We previously showed normalized protein catabolic rate (nPCR) to be superior to sAlb to reflect improvement in nutrition status in pediatric patients receiving maintenance HD after treatment with intradialytic parenteral nutrition for severe protein-energy malnutrition. We now compare nPCR and sAlb as nutrition status markers for pediatric patients on HD irrespective of current nutrition status.

RESULTS

Forty-four patients comprising 840 months of HD provision were assessed. nPCR was higher for younger patients. Mean nPCR values were significantly lower for adolescent patients with persistent weight loss of at least 2% for at least 3 consecutive months versus patients without persistent weight loss (1.03 +/- 0.29 g/kg/d vs. 1.15 +/- 0.27 g/kg/d, P < .002), and the odds for developing persistent weight loss were four times greater for adolescent patients with nPCR less than 1 g/kg/d. No association between nPCR and weight loss was observed for younger patients. Mean sAlb levels were greater than 4 g/dL for all patient age groups and did not demonstrate a clinically significant difference between patients with or without weight loss.

CONCLUSION

We suggest that nPCR may be useful for monthly nutrition status in adolescent patients receiving maintenance HD and that adolescents with nPCR less than 1 g/kg/d may be at increased risk for subsequent weight loss.

Authors+Show Affiliations

Texas Children's Hospital, Houston, Texas 77030, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17586426

Citation

Juarez-Congelosi, Marisa, et al. "Normalized Protein Catabolic Rate Versus Serum Albumin as a Nutrition Status Marker in Pediatric Patients Receiving Hemodialysis." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 17, no. 4, 2007, pp. 269-74.
Juarez-Congelosi M, Orellana P, Goldstein SL. Normalized protein catabolic rate versus serum albumin as a nutrition status marker in pediatric patients receiving hemodialysis. J Ren Nutr. 2007;17(4):269-74.
Juarez-Congelosi, M., Orellana, P., & Goldstein, S. L. (2007). Normalized protein catabolic rate versus serum albumin as a nutrition status marker in pediatric patients receiving hemodialysis. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 17(4), 269-74.
Juarez-Congelosi M, Orellana P, Goldstein SL. Normalized Protein Catabolic Rate Versus Serum Albumin as a Nutrition Status Marker in Pediatric Patients Receiving Hemodialysis. J Ren Nutr. 2007;17(4):269-74. PubMed PMID: 17586426.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Normalized protein catabolic rate versus serum albumin as a nutrition status marker in pediatric patients receiving hemodialysis. AU - Juarez-Congelosi,Marisa, AU - Orellana,Pamela, AU - Goldstein,Stuart L, PY - 2006/10/20/received PY - 2007/6/26/pubmed PY - 2007/7/21/medline PY - 2007/6/26/entrez SP - 269 EP - 74 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 17 IS - 4 N2 - BACKGROUND: Protein-energy malnutrition occurs commonly in patients receiving hemodialysis (HD). Although serum albumin (sAlb) is recommended to monitor nutrition status in patients receiving HD, many processes unrelated to nutrition status can affect albumin concentrations. METHODS: We previously showed normalized protein catabolic rate (nPCR) to be superior to sAlb to reflect improvement in nutrition status in pediatric patients receiving maintenance HD after treatment with intradialytic parenteral nutrition for severe protein-energy malnutrition. We now compare nPCR and sAlb as nutrition status markers for pediatric patients on HD irrespective of current nutrition status. RESULTS: Forty-four patients comprising 840 months of HD provision were assessed. nPCR was higher for younger patients. Mean nPCR values were significantly lower for adolescent patients with persistent weight loss of at least 2% for at least 3 consecutive months versus patients without persistent weight loss (1.03 +/- 0.29 g/kg/d vs. 1.15 +/- 0.27 g/kg/d, P < .002), and the odds for developing persistent weight loss were four times greater for adolescent patients with nPCR less than 1 g/kg/d. No association between nPCR and weight loss was observed for younger patients. Mean sAlb levels were greater than 4 g/dL for all patient age groups and did not demonstrate a clinically significant difference between patients with or without weight loss. CONCLUSION: We suggest that nPCR may be useful for monthly nutrition status in adolescent patients receiving maintenance HD and that adolescents with nPCR less than 1 g/kg/d may be at increased risk for subsequent weight loss. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/17586426/Normalized_protein_catabolic_rate_versus_serum_albumin_as_a_nutrition_status_marker_in_pediatric_patients_receiving_hemodialysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(07)00098-2 DB - PRIME DP - Unbound Medicine ER -