The Effect of Renal Dialysis On Serum Albumin In Sudanese Patients With End- Stage Renal Disease

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.