From the Guidelines
Increasing dietary protein intake to improve albumin levels is not recommended for individuals with nondialysis-dependent chronic kidney disease, as higher levels of dietary protein intake have been associated with increased albuminuria, more rapid kidney function loss, and CVD mortality. The most recent and highest quality study, 1, suggests that dietary protein intake should be approximately 0.8 g/kg body weight per day, which is the recommended daily allowance. This level of protein intake has been shown to slow GFR decline with evidence of a greater effect over time.
Some key points to consider when managing dietary protein intake for individuals with chronic kidney disease include:
- Restricting dietary sodium to <2,300 mg/day may be useful to manage blood pressure and reduce cardiovascular risk, as noted in 1 and 1.
- Individualization of dietary potassium may be necessary to manage serum potassium concentrations, particularly for individuals with reduced eGFR.
- Higher levels of dietary protein intake should be considered for individuals on dialysis, as protein-energy wasting is a major problem for some individuals on dialysis, according to 1 and 1.
- It is essential to distribute protein intake evenly throughout the day across meals and snacks for optimal absorption.
- Adequate calorie intake is also crucial, as protein will be used for energy rather than albumin synthesis if caloric needs are not met.
Regular monitoring of albumin levels through blood tests can help track improvement as dietary changes take effect. However, it is essential to prioritize the most recent and highest quality evidence, 1, which recommends a dietary protein intake of 0.8 g/kg body weight per day for individuals with nondialysis-dependent chronic kidney disease.
From the Research
Increasing Dietary Protein to Improve Albumin
- Increasing dietary protein is not directly mentioned in the provided studies as a method to improve albumin levels 2, 3, 4, 5, 6.
- The studies focus on the use of human serum albumin (HAS) solutions in patients with advanced liver diseases, such as cirrhosis, and its benefits in improving outcomes and reducing complications 2, 3, 4, 5, 6.
- The role of dietary protein in improving albumin levels is not explicitly discussed in the provided evidence.
Albumin and Liver Disease
- Low serum albumin is common in cirrhosis and is associated with reduced survival 4.
- Albumin has oncotic and non-oncotic properties, which make it beneficial in patients with liver diseases, such as improving immune cell function and mitigating the severity of infections 2, 3, 5.
- The use of HAS has been shown to improve outcomes in patients with decompensated cirrhosis, including reducing mortality and improving quality of life 4, 6.
Therapeutic Uses of Albumin
- Albumin is used in various clinical indications, including management of circulatory and renal dysfunction in patients with ascites 3.
- The therapeutic uses of albumin are being explored in various conditions, including stroke, severe sepsis, Alzheimer's disease, malaria, burns, and ovarian hyperstimulation syndrome 5.
- The role of albumin in liver disease is being investigated, with a focus on its potential to modify the course of decompensated cirrhosis and improve patient outcomes 2, 4, 6.