| [ Summary ] |
Serum albumin is used as the primary nutritional marker for patients with chronic kidney disease (CKD). However, serum albumin is affected by a variety of conditions, including inflammation, exchanges between the intra-and extravascular compartments, lymphatic uptake, alterations in volume of distribution, protein degradation, and loss of body mass. In addition, measured serum albumin levels vary in relation to the method of measurement used. The International Society of Renal Nutrition and Metabolism expert panel advocates that four main and established categories be recognized for the diagnosis of protein-energy wasting (PEW), one : biochemical tests (including serum albumin), two：reduced body weight, or body fat mass, three：a decrease in muscle mass and four：low energy and protein intake. Diagnosis of PEW is based on meeting at least three of these criteria. Therefore, it is important to assess general patient nutritional status including physical assessment of CKD patients. |