Improving Serum Albumin Levels in Hemodialysis Patients by a Continuous Quality Improvement Project

  • Richard S. Goldman
    Address correspondence to Richard S. Goldman, MD, 201 Cedar SE, Suite 801, Albuquerque, NM 87106.
    From Renal Medicine Associates, Forum of End Stage Renal Disease Networks, Board of Directors, Intermountain End Stage Renal Disease Network #15, and the University of New 1 Mexico Health Sciences Center, Albuquerque, NM
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      Protein nutrition and serum albumins predict present and future mortality and morbidity. The North East Albuquerque Dialysis Center undertook a quality improvement project to improve serum albumin levels in hemodialysis patients. The dialysis facility's quality assurance team evolved into a continuous quality improvement team just before this project. The timeline and steps in this evolution are presented. The continuous quality improvement project process analysis, interventions, and outcome rates are also described. The project has resulted in a rate of less than or equal to 10% of hemodialysis patients with serum albumins less than 3.4 for the past 3 years.

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        • Lowrie EG
        • Huang WH
        • Lew NL
        Death risk predictors among peritoneal dialysis and hemodialysis patients: A preliminary comparison.
        Am J Kidney Dis. 1995; 26: 220-228
        • Leavey SF
        • Strawderman RL
        • Jones CA
        • et al.
        Simple nutritional indicators as independent predictors of mortality in hemodialysis patients.
        Am J Kidney Dis. 1998; 31: 997-1006
        • Kaysen GA
        • Stevenson FT
        • Depner TA
        Determinants of albumin concentration in hemodialysis patients.
        Am J Kidney Dis. 1997; 29: 658-668
        • Owen Jr, WF
        • Lew NL
        • Liu Y
        • et al.
        The urea reduction ratio and serum albumin concentration as predictors of mortality in patients undergoing hemodialysis.
        N Engl J Med. 1993; 329: 1001-1006
        • Mitch WE
        • Maroni BJ
        Factors causing malnutrition in patients with chronic uremia.
        Am J Kidney Dis. 1999; 33: 176179
        • Slomowitz LA
        • Monteon FJ
        • Grosvenor M
        • et al.
        Effect of energy intake on nutritional status in maintenance hemodialysis patients.
        Kidney Int. 1989; 35: 704-711
        • Sherman RA
        • Cody RP
        • Rogers ME
        • et al.
        Interdialytic weight gain and nutritional parameters in chronic hemodialysis patients.
        Am J Kidney Dis. 1995; 25: 579-583
        • Wolfson M
        Pathogenesis and treatment of malnutrition in maintenance dialysis.
        in: Rose, BD UpToDate. Wellsley, MASept 1, 2000
        • Ikizler TA
        • Hakim RM
        Nutrition in end stage renal disease.
        Kidney Int. 1996; 50: 343-357