In preoperative evaluation of a patient with chronic kidney disease, which laboratory value best assesses nutritional status?

• A. Serum albumin
• B. Hemoglobin
• C. Sodium
• D. Creatinine

Answer: (A)

Nutritional status in a preoperative CKD patient is best gauged by serum albumin because it reflects long-term protein stores and is linked to healing, infection risk, and overall surgical risk. Albumin has a relatively long half-life, so it indicates sustained nutritional adequacy rather than short-term fluctuations. In CKD, low albumin can result from malnutrition or protein loss and inflammation, making it a practical indicator in this context. Hemoglobin measures anemia, not nutrition; sodium reflects fluid/electrolyte balance; creatinine indicates kidney function and muscle mass but not nutrition directly. Thus, albumin provides the most direct estimate of nutritional status for preoperative assessment.