Role of albumin assay on calcium levels and prescription of phosphate binders in chronic hemodialysis patients

Camiel L.M. De Roij Van Zuijdewijn, Dinky E. De Haseth, Bastiaan Van Dam, Willem A. Bax, Muriel P.C. Grooteman, Michiel L. Bots, Peter J. Blankestijn, Menso J. Nubé, Marinus A. Van Den Dorpel, Pieter M. Ter Wee, Erik L. Penne

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)211-217
Number of pages7
JournalNephron
Volume140
Issue number3
DOIs
Publication statusPublished - 1 Oct 2018

Cite this

De Roij Van Zuijdewijn, Camiel L.M. ; De Haseth, Dinky E. ; Van Dam, Bastiaan ; Bax, Willem A. ; Grooteman, Muriel P.C. ; Bots, Michiel L. ; Blankestijn, Peter J. ; Nubé, Menso J. ; Van Den Dorpel, Marinus A. ; Ter Wee, Pieter M. ; Penne, Erik L. / Role of albumin assay on calcium levels and prescription of phosphate binders in chronic hemodialysis patients. In: Nephron. 2018 ; Vol. 140, No. 3. pp. 211-217.
@article{de8387239e784c1bb020813c02ec9650,
title = "Role of albumin assay on calcium levels and prescription of phosphate binders in chronic hemodialysis patients",
abstract = "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.",
keywords = "Albumin, Assay, Calcium, Chronic kidney disease-mineral and bone disorder, Hemodialysis, Phosphate-binding agents",
author = "{De Roij Van Zuijdewijn}, {Camiel L.M.} and {De Haseth}, {Dinky E.} and {Van Dam}, Bastiaan and Bax, {Willem A.} and Grooteman, {Muriel P.C.} and Bots, {Michiel L.} and Blankestijn, {Peter J.} and Nub{\'e}, {Menso J.} and {Van Den Dorpel}, {Marinus A.} and {Ter Wee}, {Pieter M.} and Penne, {Erik L.}",
year = "2018",
month = "10",
day = "1",
doi = "10.1159/000492238",
language = "English",
volume = "140",
pages = "211--217",
journal = "Nephron",
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De Roij Van Zuijdewijn, CLM, De Haseth, DE, Van Dam, B, Bax, WA, Grooteman, MPC, Bots, ML, Blankestijn, PJ, Nubé, MJ, Van Den Dorpel, MA, Ter Wee, PM & Penne, EL 2018, 'Role of albumin assay on calcium levels and prescription of phosphate binders in chronic hemodialysis patients' Nephron, vol. 140, no. 3, pp. 211-217. https://doi.org/10.1159/000492238

Role of albumin assay on calcium levels and prescription of phosphate binders in chronic hemodialysis patients. / De Roij Van Zuijdewijn, Camiel L.M.; De Haseth, Dinky E.; Van Dam, Bastiaan; Bax, Willem A.; Grooteman, Muriel P.C.; Bots, Michiel L.; Blankestijn, Peter J.; Nubé, Menso J.; Van Den Dorpel, Marinus A.; Ter Wee, Pieter M.; Penne, Erik L.

In: Nephron, Vol. 140, No. 3, 01.10.2018, p. 211-217.

Research output: Contribution to journalArticleAcademicpeer-review

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

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U2 - 10.1159/000492238

DO - 10.1159/000492238

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JF - Nephron

SN - 1660-8151

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