Nutritional Assessment - 2 Flashcards
Considerations of pre-albumin in renal disease?
Kidney often excretes prealbumin, thus will reflect a higher value
When there a drop in visceral protein, what is it most often associated with?
Major blood loss and inflammation from surgeries, NOT indicative of nutritional status
Albumin half-life?
14-20 days
Mild depletion albumin?
28-35
Moderate depletion of albumin?
21-27
Severe depletion of albumin?
<21
Mild depletion of TIBC?
36-44
Moderate depletion of TIBC?
22-35
Severe depletion of TIBC?
<22
Half-life of pre-albumin?
1-3 days
Mild depletion of pre-albumin?
0.13-0.20
Moderate depletion of pre-albumin?
0.07-0.13
Severe depletion of pre-albumin?
<0.07
Mild depletion of TLC? Elderly?
1.5-1.8 1.2-1.8
Moderate depletion of TLC? Elderly?
0.9-1.5 0.8-1.19
Severe depletion of TLC? Elderly?
<0.9 <0.8
When are albumin, and other visceral proteins decreased?
-Inflammation -Infection -Liver disease -Protein losing states -Surgery, stress, catabolic states, malnutrition, corticosteroid therapy
In what inflammation state is pre-albumin increased?
-Corticosteroids -CKD due to less excretion
What is low albumin associated with?
Increased risk of morbidity and mortality
When does TLC increase?
-AIDS -Malignancies -immunosuppressive drugs
Patient is admitted well nourished for unexpected bowel surgery, Post-op he has a fever, and on POD 8 he is NPO for the past 8 days. Albumin = 19 g/L, what is your impression?
-Recall that 1/2 life of albumin is 14-30 days, thus it has not been enough time for albumin to be reflective of nutritional status -Likely due to fever, inflammation and post-catabolic state post Sx. -Initiate post-op nutrition to ret bowel until PO intake can resume
Patient presents w/ albumin of 36 g/L and TLC of 1.2. Impression in 40 y/o?
-Albumin reflective of mild malnutrition -Mild deficit of TLC -Thus, indicative of mild malnutrition
Patient presents w/ albumin of 36 g/L and TLC of 1.2. Impression in 80 y/o?
-Albumin good for age -Mild deficit of TLC -Nutritional status likely OK, reflective of aging and not nutritional status
Pre-albumin/trasnthyretin 1/2 life?
2-3 days
