Abstract:
This study was carried out with the pertiupation of 60 patients
with end stage renal disease (ESRD). 30 patients were seen at
Khartoum Center of Dialysis and Transplantation who were
under haemodialysis therapy, and other 30 patients were seen at
Military Hospital, Omdurman in which they were under
peritoneal dialysis. The two groups of end-stage renal disease
were nearly matched in age and sex.
Albumin concentration in each group was measured
following either renal dialysis inorder to assess the adverse
effect and to assess impact of each dialysis method on the
concentration of serum albumin.
Preliminary investation revealed that the majority of ESRD
patients in each group were presented with other disease namely
hypertension, diabetes mellitus and also infestation of Hepatitis
virus (HBV) were found in about 26% of ESRD patients under
haemodialysis and about 7% of ESRD patients under peritoneal
dialysis.
The findings of this study also showed that all patients of
ESRD of each group maintained low serum albumin
concentration pre-dialysis (below albumin reference value) and
the level markedly decreased post dialysis with varying degree,
the most serum albumin decrease was found in ESRD patients
under peritoneal dialysis. Males exhibit more reduction in
albumin concentration than females in peritoneal dialysis while
in haemodialysis, no statistical differences of albumin
concentration were found between males and females. Similarly,
peritoneal dialysis has shown severe and more reduction of
albumin concentration in ESRD patients over 50 years of age
that ESRD patients under 50 years of age, while under
haemodialysis the age appeared to has no effect on the level of
albumin concentration.
The explanation of reduced serum albumin under renal
dialysis was reported to be due to malnutrition, inflammation
and persistent fluid overload. And it is presumed that
malnutrition with low serum albumin is powerful predictor of
mortality in ESRD patients. It is also believed that fall in serum
albumin level in ESRD patients during renal dialysis is
associated with the progression of development of cardiac
failure and overall mortality and hypoalbuminaemia is
considered to be a major adverse prognostic factor in dialysis
patients, is strongly associated with cardiac disease.