From the Guidelines
A drop in total protein levels, also known as Hypoproteinemia, can be caused by several conditions including malnutrition, malabsorption disorders, liver disease, kidney disease, severe burns, and certain cancers.
Causes of Hypoproteinemia
- Malnutrition from inadequate protein intake or conditions like anorexia directly reduces available proteins 1.
- Malabsorption syndromes such as celiac disease or inflammatory bowel disease prevent proper nutrient absorption.
- Liver disease impairs protein synthesis since the liver is the primary site for albumin production.
- Kidney diseases like nephrotic syndrome cause protein loss through urine.
- Severe burns lead to protein leakage through damaged skin.
- Blood loss from trauma or surgery can also reduce total protein levels.
- Certain medications including estrogens, oral contraceptives, and some antibiotics may decrease protein levels.
- Pregnancy normally causes slight protein decreases due to hemodilution.
Protein Intake Recommendations
According to the most recent guidelines, protein intakes of 1.2 to 1.3 g/kg/d are recommended for patients with chronic renal failure 1. However, for acutely ill individuals without renal disease, higher protein intakes of 1.5 to 2.5 g/kg/d may be recommended 1.
Importance of Addressing Underlying Cause
Treatment focuses on addressing the underlying cause rather than the protein level itself. If you experience unexplained low protein levels, medical evaluation is essential to identify and treat the root cause 1.
From the FDA Drug Label
Sequestration of Protein Rich Fluids(7) This occurs in such conditions as acute peritonitis, pancreatitis, mediastinitis, and extensive cellulitis. The magnitude of loss into the third space may require treatment of reduced volume or oncotic activity with an infusion of albumin Erythrocyte Resuspension(2) Albumin may be required to avoid excessive hypoproteinemia, during certain types of exchange transfusion, or with the use of very large volumes of previously frozen or washed red cells. Hypoproteinemia With or Without Edema During major surgery, patients can lose over half of their circulating albumin with the attendant complications of oncotic deficit.(2,4,5)
Causes of Hypoproteinemia may include:
- Sequestration of protein rich fluids due to conditions such as acute peritonitis, pancreatitis, mediastinitis, and extensive cellulitis 2
- Erythrocyte resuspension during certain types of exchange transfusion, or with the use of very large volumes of previously frozen or washed red cells 2
- Major surgery, where patients can lose over half of their circulating albumin 2