Journal List > J Nutr Health > v.46(6) > 1081318

J Nutr Health. 2013 Dec;46(6):521-530. Korean.
Published online December 31, 2013.  https://doi.org/10.4163/jnh.2013.46.6.521
© 2013 The Korean Nutrition Society
Comparative study of serum levels of albumin and hs-CRP in hemodialysis patients according to protein intake levels
Ye Ji Lee,1 Yeon Joo Lee,1 Il Hwan Oh,2 Chang Hwa Lee,2 and Sang Sun Lee1
1Department of Food and Nutrition, Hanyang University, Seoul 133-791, Korea.
2Department of Nephrology, Hanyang University Seoul Hospital, Seoul 133-792, Korea.

To whom correspondence should be addressed. (Email: leess@hanyang.ac.kr )
Received August 20, 2013; Revised September 06, 2013; Accepted November 18, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Protein-energy malnutrition, PEM, and increased hs-CRP level are considered to be associated with increased risk of cardiovascular disease (CVD) in hemodialysis (HD) patients. This is commonly referred to as the vicious circle of malnutrition-inflammation-atherosclerosis cardiovascular disease (MIA syndrome) in chronic kidney disease (CKD). Low protein intake can decrease the serum level of albumin and increase inflammational markers; further, both low serum albumin and high hs-CRP are independent risk factors for all-cause mortality in HD patients. The aim of this study is comparing the serum levels of albumin and hs-CRP in HD patients according to the protein intake levels. The total number of subjects was 60 hemodialysis patients; they were grouped by dietary protein intake: low protein intake group (LPI, protein intake < 1.0 g/kg IBW, 11 men and 19 women) and adequate protein intake group (API, protein intake ≥ 1.0 g/kg IBW, 12 men and 18 women). Blood biochemical parameters, nutrient intake, and dietary behaviors were compared between the LPI and API groups. The LPI group showed a significantly lower serum level of albumin and higher serum level of hs-CRP than the API group (p < 0.05). The LPI group showed a significantly lower intake of most nutrients than the API group (p < 0.05). Index of Nutritional Quality of most nutrients of the LPI and API groups were lower than 1.0. Dietary protein intake was positively correlated with the serum level of albumin (r = 0.306, p < 0.05) and negatively correlated with the serum level of hs-CRP (r = -0.435, p < 0.01). The serum level of hs-CRP was negatively correlated with that of albumin (r = -0.393, p < 0.01). According to these result, serum albumin and hs-CRP in HD patients were influenced by the protein intake levels. To prevent MIA syndrome, it is necessary to improve nutritional status, especially in protein and energy.

Keywords: hemodialysis patients; serum albumin; hs-CRP; protein intake; MIA syndrome National Research Foundation 2012R1A1A2008077

Tables


Table 1
General characteristics of the subjects according to the protein intake
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Table 2
Blood biochemical parameters of the subjects according to the protein intake
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Table 3
Nutrient intakes and frequency of protein foods of the subjects according to the protein intake
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Table 4
Assessment of nutrient intakes less than RNI1) and EAR2) of the subjects according to the protein intake n (%)
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Table 5
Index of nutritional quality of the subjects according to the protein intake
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Table 6
Korean's Dietary Diversity Score (KDDS) and food group intake pattern (CMVDO) of the subjects according to the protein intake n (%)
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Table 7
Correlation between dietary intakes and blood biochemical parameters of the subjects
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Notes

This work was supported by grants of the National Research Foundation of Korea (2012R1A1A2008077).

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