II. Indications
- Malnutrition Evaluation (See Malnutrition Labs)
- Monitoring of nutritional improvement
III. Efficacy
- Correlates with clinical outcomes
- Prealbumin is the best marker of Malnutrition
- Short serum Half-Life
- Less affect by liver disease than other Proteins
- Not affected by hydration status
- Not affected by Vitamin Deficiency (except zinc)
IV. Pathophysiology
- Serum Half-Life: 2 days
- High essential to Nonessential Amino Acid ratio
- Production
V. Normal
- Prealbumin: 16 to 35 mg/dl
VI. Increased Serum Prealbumin
-
Alcohol Abuse (especially binge drinking)
- Prealbumin returns to baseline after 7 days
- Medications
- Corticosteroids (e.g. Prednisone)
- Progesterone and related agents
VII. Decreased Serum Prealbumin
- Protein Malnutrition
- Other Causes
- Zinc Deficiency
- Negative acute phase reactant
- Decreases with inflammation or post-surgery
VIII. Interpretation in Malnutrition
- Protein Malnutrition Diagnosis
- Prealbumin <5 mg/dl: Predicts poor prognosis
- Prealbumin <11 mg/dl: High risk
- Requires aggressive Nutritional Supplementation
- Prealbumin <15: Increased risk of Malnutrition
- Monitoring recommended twice weekly
- Reference
- Protein Malnutrition Monitoring
- Findings suggestive of adequate Nutritional Support
- Prealbumin level rising 2 mg/dl per day
- Prealbumin level returns to normal by 8 days
- Findings requiring intense nutritional (e.g. TPN)
- Prealbumin level rises <4 mg/dl in 8 days
- Findings suggestive of adequate Nutritional Support