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Albumin concentration determined by the modified bromocresol purple method is superior to that by the bromocresol green method for assessing nutritional status in malnourished patients with inflammation

2013; SAGE Publishing; Volume: 50; Issue: 6 Linguagem: Inglês

10.1177/0004563213480137

1758-1001

Tsuyoshi Ueno, Satoshi Hirayama, Masayuki Itô, Emiko Nishioka, Yoshifumi Fukushima, T Satoh, Mayumi Idei, Yuki Horiuchi, Hiromichi Shoji, Hirotoshi Ohmura, Toshiaki Shimizu, Takashi Miida,

Dialysis and Renal Disease Management

Background The controlling nutritional status (CONUT) score (CS), a simple score for assessing nutritional status, is calculated using laboratory data, including serum albumin concentration. Although dye-binding assays such as the bromocresol green (BCG) and modified bromocresol purple (mBCP) methods are widely used for albumin measurement, acute-phase proteins interfere with the BCG method. Objective We aimed to determine whether the choice of albumin assay affects assessment of nutritional status using CONUT scores (CSs). Design We measured serum albumin concentrations by the BCG (ALB BCG ) and mBCP (ALB mBCP ) methods in 44 malnourished inpatients, 27 of whom underwent nutritional intervention, and compared them to 30 age-matched healthy volunteers. In treated patients, CSs were calculated by ALB BCG (CS-BCG) and ALB mBCP (CS-mBCP). Results C-reactive protein (CRP) concentrations were positively correlated with the difference between ALB BCG and ALB mBCP in malnourished inpatients ( r = 0.59, p < 0.001). CS-BCG was always lower than CS-mBCP (lower CS indicates superior nutritional status) in treated patients with persistently high CRP levels. However, in patients whose CRP decreased gradually, this difference diminished over the clinical course. CS-BCG and CS-mBCP were similar throughout their courses in patients with normal CRP concentrations. Adding haptoglobin to the human albumin solutions increased ALB BCG in a dose-dependent manner. Conclusions The choice of albumin assay affected the assessment of nutritional status using CSs in patients with inflammation. We recommend that the modified BCP assay be used to assess nutritional status, particularly in patients with inflammation.