Albumin Kinetics and Nutritional Rehabilitation in the Unattended Home-Dialysis Patient

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Abstract
Forty-six patients with chronic renal failure were trained in a home-dialysis program and followed for six to 42 months. All were given a diet containing 80 g per day of protein. They carried out dialysis three times a week for a total of 24 to 30 hours. After six to 42 months, 41 had gained 1 to 45 per cent of their initial weight, four had no change in weight, and one had lost weight. Mean albumin concentration increased from 3.3 to 4.4 g per 100 ml during the period of observation. Changes from normal as measured by 125l-labeled albumin in eight patients included an increased plasma volume (58 vs. 41 ml per kilogram), increased intravascular albumin (2.6 vs. 1.7 g per kilogram), and a total exchangeable albumin (6.2 vs. 3.7 g per kilogram). The albumin half-life and albumin turnover rates were normal. Thirty-six patients returned to full activity, and 10 resumed part-time activities. nutritional rehabilitation thus was possible with frequent dialysis and a relatively normal protein intake.