In preoperative evaluation of a client with chronic renal disease, which laboratory value is commonly assessed to evaluate nutritional status?

• A. Hemoglobin
• B. Serum albumin
• C. Serum creatinine
• D. Potassium

Answer: (B)

The main idea here is that proper nutrition, especially protein stores, strongly influences surgical healing and resistance to infection. Serum albumin is a commonly used indicator of visceral protein reserves and overall nutritional status. In someone with chronic kidney disease, assessing nutrition helps predict wound healing and postoperative complications, and albumin levels tend to reflect long-standing protein intake and body protein stores more than other routine labs.

Albumin is produced by the liver, and its level decreases with inadequate protein intake or with inflammatory states that drive a decrease in hepatic production of albumin. In the preoperative setting, a low albumin level has been associated with poorer wound healing, higher infection risk, and increased mortality, making it a useful single measure of nutritional risk.

The other labs don’t serve as direct proxies for nutrition. Hemoglobin measures oxygen-carrying capacity and can be affected by anemia of chronic disease or renal failure, but it doesn’t specifically indicate nutritional reserves. Serum creatinine relates to muscle mass and kidney function rather than nutritional status, and potassium reflects electrolyte balance and renal handling, not nutrition per se.