From the Guidelines
Increased albumin levels are most commonly caused by dehydration, which concentrates albumin in the bloodstream, and other factors such as excessive protein intake, anabolic steroid use, and certain medications like corticosteroids 1. When considering the cause of increased albumin, it's essential to evaluate the patient's overall clinical context, including their hydration status, medication use, and dietary habits.
- Dehydration is a common cause of hyperalbuminemia, as it reduces the fluid volume in the bloodstream, thereby concentrating albumin 1.
- Excessive protein intake can also lead to increased albumin production, as the liver produces albumin in response to high protein levels in the diet.
- Certain medications, such as corticosteroids, can stimulate the liver to produce more albumin, resulting in elevated levels in the blood 1.
- Anabolic steroid use has also been linked to increased albumin production, although this is less common compared to other causes. It's crucial to address the underlying cause of hyperalbuminemia rather than the elevated albumin itself, as this can help prevent potential complications and improve patient outcomes 1. For example, if dehydration is the cause, proper hydration with oral fluids or IV fluids like normal saline may be recommended, while medication-induced increases may require adjusting dosages or switching medications under medical supervision 1.
From the Research
Causes for Increased Albumin
- The use of albumin and diuretic therapy, such as furosemide, can lead to increased urine volume and sodium levels in patients with nephrotic syndrome 2
- Co-administration of albumin and furosemide can improve edema by diuresis and natriuresis in patients with nephrotic syndrome who have not responded to diuretics alone 3, 2
- Albumin infusion can result in increased oncotic pressure, which can help to reduce edema in patients with nephrotic syndrome 2, 4
- However, albumin infusion has also been associated with an increased risk of acute kidney injury (AKI) in adult patients with minimal change disease 5
- The administration of albumin with diuretics can also lead to complications such as hypertension, hypokalemia, hypernatremia, and hyperbicarbonatemia 4
Mechanisms of Action
- The combination of albumin and furosemide can increase the glomerular filtration rate (GFR) and enhance the diuretic effects of furosemide 2
- Albumin infusion can help to correct reduced oncotic pressure, which can contribute to edema in patients with nephrotic syndrome 2, 4
- The increased urine volume and sodium levels seen with albumin and diuretic therapy can help to reduce edema in patients with nephrotic syndrome 2
Clinical Implications
- The use of albumin and diuretic therapy should be carefully considered in patients with nephrotic syndrome, taking into account the potential benefits and risks 3, 2, 5, 4
- Patients with minimal change disease may be at increased risk of AKI with albumin infusion, and alternative treatments should be considered 5
- Close monitoring of patients receiving albumin and diuretic therapy is necessary to prevent complications such as hypertension, hypokalemia, and hypernatremia 4