PDF Clinical Significance of Prealbumin

Clinical Significance of Prealbumin & Nutrition Support

* Prealbumin (PAB) half-life is 48-72 hours

*PAB may not be a sensitive marker for evaluating the adequacy of nutrition support in critically ill patients with inflammation.

*The liver synthesizes acute-phase proteins such as C-reactive protein (CRP) at the expense of PAB. If checking PAB, consider ordering CRP as well.

*ALB and PAB levels will remain depressed despite optimal nutrition support until inflammation/stress is resolved.

*Increases in PAB rely on improvement in inflammation, rather than nutrient intake.

*Decreased PAB suggests pt is very ill and may require aggressive nutrition support.

*PAB is decreased with:

*PAB is falsely increased 2?:

-POST SURGERY

-Chronic renal failure

-Acute catabolic states/stress

-Corticosteroid use

-Inflammation

-Oral contraceptive use

-Liver disease

-Infection

-Significant hyperglycemia

-Fuhrman MP et al: Hepatic proteins and nutrition assessment. J Am Diet Assoc 2004; 104:1258-1264. -Davis CJ et al: The use of prealbumin and C-reactive protein for monitoring nutrition support in adult patients receiving enteral nutrition in an urban medical center. J Parenteral and Enteral Nutrition 2012; 36:197.

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