From the Guidelines
When checking nutrition, I recommend ordering a comprehensive panel that includes routine electrolyte, mineral (calcium, phosphorus, and magnesium), triglyceride, serum urea, haemoglobin, total lymphocyte count, and pre-albumin or retinol-binding protein levels. This is based on the most recent evidence from the Clinical Nutrition journal 1, which suggests that these laboratory tests can help determine nutritional deficiencies and identify malnutrition.
Key Laboratory Tests
- Routine electrolyte, mineral (calcium, phosphorus, and magnesium), triglyceride, and serum urea determination to help determine nutritional deficiencies 1
- Haemoglobin and total lymphocyte count to help identify malnutrition 1
- Pre-albumin or retinol-binding protein levels to reflect improving nutritional status better than albumin 1
Additional Considerations
- Albumin levels can be low due to acute phase response to inflammation and redistribution of protein, so hypo-albuminaemia should not be attributed to malnutrition alone 1
- Other laboratory tests, such as nitrogen excretion, nitrogen balance, and plasma amino acid profile, can help characterize protein deficit but are not commonly used in clinical practice 1
- Serum vitamin and trace element concentrations should be evaluated in long-term PN dependent patients 1