From the Guidelines
Normal albumin levels should be maintained between 3.5 to 5.0 g/dL to minimize the risk of technique failure and death in patients, as evidenced by the strong association between low serum albumin levels and increased risk of adverse outcomes 1.
Importance of Albumin Levels
Albumin is a crucial protein in the blood, responsible for maintaining oncotic pressure, transporting substances, and acting as a buffer for blood pH. Low albumin levels, or hypoalbuminemia, can indicate various health issues, including liver disease, kidney disease, malnutrition, inflammation, or protein-losing conditions.
Monitoring and Maintaining Normal Albumin Levels
Monitoring serum albumin concentration is recommended on a regular basis, at least every 4 months, as it is associated with important outcomes such as technique failure and death 1. A stable or rising albumin value is desirable, and the highest albumin level possible should be the goal for each patient. This can be achieved through adequate nutrition, prevention and treatment of catabolic illness, and maintenance of Kt/Vurea and creatinine.
Clinical Implications
Patients with low albumin levels may experience edema, particularly in the extremities, due to fluid leakage from blood vessels into surrounding tissues. Clinicians use albumin levels as part of a comprehensive metabolic panel to assess nutritional status and organ function. The presence of comorbid conditions, such as diabetes, can also impact albumin levels, highlighting the need for individualized assessment and management 1.
Key Considerations
- Serum albumin concentration should be monitored regularly and evaluated in the context of the patient's overall clinical status.
- A decrease in serum albumin level, even by 0.1 g/dL/month, may indicate malnutrition or decreasing protein stores and should be addressed promptly.
- Local laboratory standards should be used to determine normal serum albumin concentrations, as these can vary by methodology 1.
From the Research
Normal Albumin Levels and Functions
- Albumin is the most abundant plasmatic protein, produced by the liver, with various metabolic functions 2
- It serves as an indicator of malnutrition, but its levels can be influenced by factors other than nutrition, such as inflammatory states and age 2
- Normal albumin levels are essential for maintaining various physiological functions, including oncotic pressure, immunomodulation, and antioxidant effects 3
Clinical Significance of Albumin
- Hypoalbuminemia is a mortality prognostic factor in elderly people, whether they live in the community or are in hospital or institutionalized 2
- Low albumin levels are associated with worse recovery following acute pathologies and increased risk of post-surgery complications, especially infections 2
- Albumin infusion has been used to improve renal function in cirrhosis, and its importance is being redefined in critically ill patients 4
Therapeutic Implications of Albumin
- Albumin infusion has been shown to ameliorate cirrhosis-associated complications, such as ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome 5
- However, albumin infusion is not a generic treatment option for all cirrhosis patients, and its use should be carefully considered based on individual patient needs 5
- The use of human albumin in patients with minimal change disease remains controversial, and its infusion may be associated with an increased risk of acute kidney injury 6