MỐI LIÊN QUAN GIỮA ALBUMIN MÁU VÀ TÌNH TRẠNG THỪA DỊCH Ở BỆNH NHÂN LỌC MÁU CHU KỲ TẠI BỆNH VIỆN LÊ VĂN THỊNH

Abstract

Background: Extracellular fluid overload is a common complication in maintenance hemodialysis (MHD) patients and is associated with adverse cardiovascular outcomes. Serum albumin reflects nutritional status and plays a role in fluid distribution. Several studies have used the threshold of <38 g/L to identify the risk of oncotic pressure disturbances and fluid imbalance [1],[2]. Objective: To assess the association between serum albumin levels and fluid overload using the ECW/TBW ratio; and to identify related factors. Methods: A cross-sectional study was conducted on 148 MHD patients at Le Van Thinh Hospital. Serum albumin and ECW/TBW were measured before dialysis using the InBody BWA 2.0 device. Patients were categorized by albumin level (<38 or ≥38 g/L) and fluid status (ECW/TBW >0.4). Clinical and paraclinical parameters were compared using appropriate statistical tests. Results: Patients with albumin <38 g/L were older on average, had lower serum potassium levels, and higher ECW/TBW ratios (p < 0.001; 0.0129; 0.091). The fluid-overloaded group was older, had lower albumin levels, and a higher prevalence of diabetes and anuria. Serum albumin was inversely correlated with ECW/TBW (r = –0.2253; p = 0.0059). Conclusion: Low serum albumin is associated with fluid overload and risk factors such as older age, hypokalemia, and loss of residual urine. Routine monitoring of albumin and ECW/TBW may help detect fluid overload early in MHD patients.