Abstract: SA-PO0881
A Three-Step Protein Supplement Protocol Reduces Prevalence of Hypoalbuminemia in a US Urban Dialysis Center
Session Information
- Health Maintenance, Nutrition, and Metabolism
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Kraus-McLean, Xander S., Intermountain Medical Center, Murray, Utah, United States
- Chemiti, Gopal, Intermountain Medical Center, Murray, Utah, United States
- Kraus, Mark A., Intermountain Medical Center, Murray, Utah, United States
Background
Hypoalbuminemia is a common complication seen in dialysis patients due to chronic inflammation, malnutrition, and protein loss due to ongoing kidney dysfunction or protein-losing enteropathy. Hypoalbuminemia is a risk factor for both mortality and morbidity. This study aimed to assess the effects of a 3-step approach to hypoalbuminemia in an urban dialysis center in the USA.
Methods
This study was conducted in a single urban dialysis center in the USA from December 2023 to February 2026. Patients unable to take oral protein supplementation were excluded. Monthly labs were used to identify patients with hypoalbuminemia. Data was collected as serial measurements of serum albumin and provided protein supplements (nutrasource Renal and Liquicel). The 3 steps of the protein supplement protocol are: (1): if albumin level was less than 3.7, a single 237 ml container of Novasource was provided; (2): if albumin level was less than 3.5 after 3 months, a 30 gm dose of Liquicel was added; (3): if albumin remained less than 3.5 at another three months, IDPN was considered. The protein supplement regimen was administered three times a week during the dialysis session. The impact of the protocol change was evaluated by comparing the preceding six months of data prior to the change as control with quarterly data collected afterward.
Results
Monthly census averaged 67.3 patients. The mean number of patients with serum albumin <3.5 mg/dl significantly decreased from pre- (6.83) to post-implementation of the 3-step supplement protocol at most time points (2.67, 2.0, 3.67, 5.33, 3.67, 3.67, 2.33) including in the first 3 months. There was no statistical difference in the 4th quarter post-implementation. At that time, an unusually high number of incident patients were started on dialysis (12) and may account for this variability. But, importantly, within 3 months the low number of hypoalbuminemic patients was reestablished. As expected, use of novasource increased after protocol implementation (3.5 vs 14, 16.3, 17, 15, 16.6, 15, 12 patients) and liquicell use decreased (13.7 vs 9, 6.3, 6, 7.6, 4.3, 4.3 patients) over the same time periods. There was minimal use of IDPN (0-1/month).
Conclusion
Implementation of a 3-step protein supplement protocol in an urban dialysis unit in the USA led to a rapid and sustained decrease in the number of patients with hypoalbuminemia in our urban dialysis unit.
Acknowledgment
Special thanks to Amanda Butz, RD