From the Guidelines
Hypoalbuminemia in the comprehensive metabolic panel (CMP) indicates a low level of albumin in the blood, which can be caused by various factors such as malnutrition, liver disease, kidney disease, or certain medications 1, 2.
Possible Causes and Implications
- Malnutrition: can lead to hypoalbuminemia due to inadequate protein intake, which can be addressed by increasing protein consumption through foods like lean meats, fish, eggs, dairy products, and legumes 3.
- Liver disease: can cause hypoalbuminemia due to impaired liver function, which can be treated with medications like ursodiol (500 mg twice daily) to improve liver function 1.
- Kidney disease: can lead to hypoalbuminemia due to protein loss in the urine, which can be managed with medications like angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril (10-40 mg daily), to slow disease progression 1.
Clinical Significance
Hypoalbuminemia is associated with a poor prognosis in various pathologic conditions, including increased risk of morbidity and mortality 1, 2.
Management and Monitoring
It is essential to work closely with a healthcare provider to determine the underlying cause of hypoalbuminemia and develop an individualized treatment plan, including regular monitoring of albumin levels and overall health to ensure effective management and prevent potential complications 3, 1, 2.
Inflammatory Marker
Albumin levels can also be regarded as an inflammatory marker associated with nutritional risk, which must be taken into context during nutrition assessment to identify patients at risk for poor outcomes 2.
From the Research
Hypoalbuminemia in Comprehensive Metabolic Panel (CMP)
Hypoalbuminemia refers to low levels of albumin in the blood. Albumin is a protein made by the liver and is a key component of blood plasma.
- Low albumin levels can be caused by various factors, including liver disease, nephrotic syndrome, and malnutrition 4, 5, 6, 7.
- In the context of chronic kidney disease (CKD), hypoalbuminemia is often associated with proteinuria, which is the presence of excess proteins in the urine 4, 5, 6, 7.
- A low-protein diet is often recommended for patients with CKD to reduce proteinuria and slow the progression of the disease 4, 5, 6, 7.
- However, a low-protein diet can also lead to malnutrition and protein-energy wasting if not properly managed 5, 6, 7.
- Some studies suggest that a plant-dominant low-protein diet may be beneficial for patients with CKD, as it can help reduce uremic burden and metabolic complications 7.
Indications of Hypoalbuminemia
Hypoalbuminemia can be indicated by various symptoms and test results, including:
- Low albumin levels in blood tests 4, 5, 6, 7
- Edema, which is swelling caused by excess fluid in the body 4, 5, 6, 7
- Fatigue and weakness 5, 6, 7
- Poor wound healing 5, 6, 7
Management of Hypoalbuminemia
The management of hypoalbuminemia depends on the underlying cause of the condition.
- In patients with CKD, a low-protein diet may be recommended to reduce proteinuria and slow the progression of the disease 4, 5, 6, 7.
- Albumin replacement therapy may be necessary in some cases, particularly in patients with severe hypoalbuminemia 4, 5, 6, 7.
- Malnutrition and protein-energy wasting should be prevented or treated with adequate nutrition and dietary supplements 5, 6, 7.