From the Guidelines
Hypoalbuminemia, or low albumin on bloodwork, is a condition where the level of albumin protein in the blood is below the normal range of 3.5-5.0 g/dL, and it is associated with an increased risk of morbidity and mortality, particularly in patients with chronic diseases such as kidney disease or liver disease. Albumin is produced by the liver and serves several important functions, including maintaining fluid balance in the bloodstream, transporting hormones and medications, and providing nourishment. Low albumin can result from liver disease, kidney disease, malnutrition or poor protein intake, inflammatory conditions, or severe burns. Symptoms might include swelling (edema), especially in the legs and abdomen, fatigue, and muscle weakness.
According to the most recent and highest quality study, treatment of hypoalbuminemia should focus on addressing the underlying cause rather than the albumin level itself 1. For example, liver disease might require specific medications or lifestyle changes, while malnutrition would be addressed through dietary improvements or supplements. If you have low albumin, your doctor will likely order additional tests to determine the cause and develop an appropriate treatment plan.
Some key points to consider in the management of hypoalbuminemia include:
- Monitoring serum albumin concentration on a regular basis, with a stable or rising value being desirable 1
- Evaluating serum albumin levels in the context of the patient's overall clinical status, including comorbid diseases, peritoneal transport type, delivered dose of peritoneal dialysis, and quality-of-life issues 1
- Aiming for the highest albumin level possible, which can be obtained by adequate nutrition, prevention and treatment of catabolic illness, and maintenance of Kt/Vurea and creatinine 1
- Considering the potential complications of hypoalbuminemia, such as increased risk of morbidity and mortality, and taking steps to mitigate these risks 1
Overall, the management of hypoalbuminemia requires a comprehensive approach that takes into account the underlying cause of the condition, as well as the patient's overall health status and quality of life. By addressing the underlying cause and monitoring serum albumin levels, healthcare providers can help to mitigate the risks associated with hypoalbuminemia and improve patient outcomes.
From the Research
Definition of Hypoalbuminemia
- Hypoalbuminemia refers to a condition where the level of albumin in the blood is lower than normal 2.
- Albumin is a protein that accounts for 60-75% of the oncotic pressure in plasma and is the most abundant protein in plasma 2.
Causes of Hypoalbuminemia
- The underlying causes of hypoalbuminemia include protein energy malnutrition, crystalloid overload, inflammation, and liver dysfunction 2.
- Other significant causes of hypoalbuminemia include liver dysfunction and serous losses, which may occur singly or in combination in any particular case 2.
- Inflammation can increase capillary permeability and escape of serum albumin, leading to expansion of interstitial space and increasing the distribution volume of albumin 3.
Clinical Significance of Hypoalbuminemia
- Hypoalbuminemia has proved to be an indicator of morbidity and mortality risk, as the underlying conditions that cause it are themselves risk factors 2.
- Hypoalbuminemia is associated with poor quality of life and reduced longevity, and increasing or decreasing serum albumin levels are adequate indicators of improvement or deterioration of the clinical state 3.
- Hypoalbuminemia is a strong prognosticator of increased all-cause and cardiovascular mortality according to several cohort studies and meta-analyses in hospitalized and non-hospitalized patients with or without comorbidities 4.
Treatment of Hypoalbuminemia
- Treatment of hypoalbuminemia is focused on diagnosing and managing the underlying condition, rather than albumin supplementation 4.
- Management of hypoalbuminemia should be based on correcting the causes of ongoing inflammation rather than infusion of albumin 3.
- Albumin infusion has not been shown to diminish fluid requirements, infection rates, and mortality in the intensive care unit 3.