From the Guidelines
To increase albumin levels, it is recommended to use albumin infusion, specifically 1.5 g albumin/kg within 6 hours of diagnosis, followed by 1 g/kg on day 3, as this has been shown to prevent renal dysfunction and decrease mortality in patients with SBP 1. When considering ways to increase albumin levels, several factors come into play, including dietary changes, supplements, and medical interventions.
- Consuming protein-rich foods like eggs, lean meats, dairy products, and legumes, aiming for 1-1.5 grams of protein per kilogram of body weight daily, can help improve albumin levels.
- Staying well-hydrated and maintaining a balanced diet with adequate calories is also essential.
- For those with severe hypoalbuminemia (albumin below 3.5 g/dL), medical intervention may be necessary, including albumin infusions (typically 25% albumin solution at 50-100g doses) for critically low levels.
- Underlying conditions causing low albumin, such as liver disease, kidney problems, or malnutrition, must be addressed.
- Supplements that may help include whey protein (20-30g daily) and zinc (15-30mg daily).
- Regular exercise can also improve albumin synthesis.
- Avoiding alcohol and smoking, which can impair liver function, is also crucial. Additionally, branched-chain amino acid (BCAA) supplementation has been shown to improve nitrogen balance, hepatic encephalopathy, and liver enzyme profiles in patients with hypo-albuminemia, and may be a useful adjunctive therapy 1. However, the most effective approach to increasing albumin levels is to use albumin infusion as recommended, as this has been shown to have a significant impact on preventing renal dysfunction and decreasing mortality in patients with SBP 1.
From the Research
Increasing Albumin Levels
To increase albumin levels, several strategies can be employed:
- Addressing nutritional barriers, such as poor nutritional knowledge, poor appetite, and difficulty swallowing, can help improve albumin levels 2
- Increasing energy and protein intake can also contribute to higher albumin levels 2
- In patients with chronic liver disease, albumin infusion can be beneficial in preventing and treating specific complications, such as paracentesis-induced circulatory dysfunction and renal dysfunction induced by spontaneous bacterial peritonitis 3
- Long-term albumin administration in patients with decompensated cirrhosis has been shown to reduce mortality and incidence of complications, and ease the management of ascites 3
Managing Hypoalbuminemia
Hypoalbuminemia is often associated with inflammation, and managing the underlying inflammatory state is crucial:
- Correcting the causes of ongoing inflammation, rather than relying solely on albumin infusion, is recommended 4
- Nutrition support, combined with physical exercise, can help slow down the decline in muscle mass and function, and associated decrease in serum albumin levels 4
Therapeutic Implications
Albumin has a wide range of physiologic functions, including immunomodulation, endothelial stabilization, antioxidant effects, and binding multiple drugs, toxins, and other molecules: