Pre-dialysis serum albumin is a poor indicator of nutritional status in stable chronic haemodialysis patients

The correlation between pre-dialysis serum albumin and mortality has been linked with malnutrition. We measured pre and post-dialysis albumin in 86 stable haemodialysis patients and compared them with anthropometric measurements and body mass index (BMI). On the basis of pre-dialysis albumin 13% of patients would be classified as high risk, whilst on the basis of post-dialysis albumin only 12% would be classified as high risk. Change in albumin could be predicted by fluid removal during haemodialysis. Pre-dialysis albumin correlated weakly with mid upper arm circumference (MUAC). Post dialysis albumin correlated with MUAC and triceps skin fold thickness (TSF). There was a weak negative correlation between age and post-dialysis albumin. TSF strongly correlated with MUAC and BMI. Pre-dialysis albumin appears to be a poor predictor of nutritional status and does not correlate well with other nutritional parameters. The excess risk of death associated with a low pre-dialysis albumin may be related to fluid overload rather than malnutrition.