TY - JOUR
T1 - Role of albumin assay on calcium levels and prescription of phosphate binders in chronic hemodialysis patients
AU - De Roij Van Zuijdewijn, Camiel L.M.
AU - De Haseth, Dinky E.
AU - Van Dam, Bastiaan
AU - Bax, Willem A.
AU - Grooteman, Muriel P.C.
AU - Bots, Michiel L.
AU - Blankestijn, Peter J.
AU - Nubé, Menso J.
AU - Van Den Dorpel, Marinus A.
AU - Ter Wee, Pieter M.
AU - Penne, Erik L.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Background/aims: In hemodialysis (HD) patients, the bromcresol green (BCG) assay overestimates, whereas the bromcresol purple (BCP) assay underestimates albumin concentration. Since corrected calcium concentrations depend on albumin, the albumin assay may have implications for the management of bone mineral disorders. Methods: A subset of patients from CONTRAST, a cohort of prevalent HD patients, was analyzed. Bone mineral parameters and prescription of medication were compared between patients in whom albumin was assessed by BCP versus BCG. Results: Albumin was assessed by BCP in 331 patients (9 of 25 centers) and by BCG in 175 patients (16 of 25 centers). Albumin was the lowest in the BCP group (34.5 ± 4.2 vs. 40.3 ± 3.1 g/L; p < 0.0005). Measured calcium levels and the prescription of calcium-based phosphate binders were similar in both groups. Corrected calcium levels, however, were markedly higher in the BCP group (2.45 ± 0.18 vs. 2.33 ± 0.18 mmol/L; p < 0.0005). Conclusion: These findings suggest that calcium levels are not corrected for albumin in clinical practice when considering the prescription of calcium-free or calcium-based phosphate-binders in dialysis patients.
AB - Background/aims: In hemodialysis (HD) patients, the bromcresol green (BCG) assay overestimates, whereas the bromcresol purple (BCP) assay underestimates albumin concentration. Since corrected calcium concentrations depend on albumin, the albumin assay may have implications for the management of bone mineral disorders. Methods: A subset of patients from CONTRAST, a cohort of prevalent HD patients, was analyzed. Bone mineral parameters and prescription of medication were compared between patients in whom albumin was assessed by BCP versus BCG. Results: Albumin was assessed by BCP in 331 patients (9 of 25 centers) and by BCG in 175 patients (16 of 25 centers). Albumin was the lowest in the BCP group (34.5 ± 4.2 vs. 40.3 ± 3.1 g/L; p < 0.0005). Measured calcium levels and the prescription of calcium-based phosphate binders were similar in both groups. Corrected calcium levels, however, were markedly higher in the BCP group (2.45 ± 0.18 vs. 2.33 ± 0.18 mmol/L; p < 0.0005). Conclusion: These findings suggest that calcium levels are not corrected for albumin in clinical practice when considering the prescription of calcium-free or calcium-based phosphate-binders in dialysis patients.
KW - Albumin
KW - Assay
KW - Calcium
KW - Chronic kidney disease-mineral and bone disorder
KW - Hemodialysis
KW - Phosphate-binding agents
UR - http://www.scopus.com/inward/record.url?scp=85053764694&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85053764694&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30212837
U2 - https://doi.org/10.1159/000492238
DO - https://doi.org/10.1159/000492238
M3 - Article
C2 - 30212837
SN - 1660-8151
VL - 140
SP - 211
EP - 217
JO - NEPHRON
JF - NEPHRON
IS - 3
ER -