Background: Inflammatory process has a substantial contribution in the development of anemia in chronic hemodialysis patients. Low serum albumin in hemodialysis patients is considered a marker of inflammation. The present longitudinal study aimed to determine the relationship between low baseline serum albumin and future development of anemia.

 Methods: The population of this study consisted of all patients on standard maintenance hemodialysis for at least three months or longer. Patients were classified as high or low serum albumin level (≥ or < 3.9 gr/dl). All patients received the standard treatment of anemia. The main objective of this study was to compare the prevalence of anemia defined as hemoglobin levels < 11 gr/dl between the two study groups at the end of the study period.

 Results: A total of 82 patients (50% females) with mean±SD age of 55±16.8 years and mean dialysis duration of 5.2±4 years were followed-up for an average period of 10±1 (range, 8-11) months, however 48 patients with high serum albumin and 24 patients with low serum albumin group completed the study. At baseline, the two groups were similar regarding hemoglobin (9.8±1.2 vs 9.16±1.6 gr/dl, P=0.95) levels. At endpoint, prevalence of anemia in high albumin group was significantly lower than the low albumin group (50% versus 83.3% P=0.005).

 Conclusion: The findings of this study indicate that low serum albumin in hemodialysis patients is a predictor of anemia indicating unresponsiveness to conventional treatment of anemia.