Ed first showed it in 1989. It has continued to be shown at every symposium I have been to since 1989. It essentially says the lower the albumin, the higher the odds ratio of death. The traditional nephrologist looks at that as saying the patient is not getting enough protein intake. The albumin doesn't go up.
Nothing ever changes.
They went on to say that the cause is probably not decreased nutrient intake. Without showing you any data, I ask you to look at the data when the supplement comes out. I actually analyzed the data at the ASN this year, and I believe you will come to the conclusion that ESRD and dialysis leads to inflammation, leading to malnutrition, leading to altered body composition of protein, both visceral protein and albumin or somatic protein, as in creatinine. The adequacy of the body's content of protein is strongly associated with the likelihood of survival. We need to stop thinking of malnutrition as simply an eating problem.