Treatment of Elevated Albumin
Clarification: Elevated Albumin is Not a Primary Treatment Target
Elevated serum albumin is not a pathological condition requiring treatment—it is typically a marker of dehydration or hemoconcentration, and the underlying cause should be addressed rather than the albumin level itself. 1, 2
Understanding the Context
The evidence provided focuses extensively on low albumin (hypoalbuminemia) in liver disease and diabetes-related kidney disease, not elevated albumin. This is because:
- Albumin is synthesized exclusively by the liver and reduced levels indicate hepatic dysfunction or protein loss 3, 2
- Elevated albumin occurs primarily from volume depletion/dehydration, causing hemoconcentration of plasma proteins 1, 2
- No clinical guidelines address "treatment" of elevated albumin because it is not a disease state requiring intervention 1
Clinical Approach to Elevated Albumin
Identify the Underlying Cause
The appropriate management is to identify and treat the cause of hemoconcentration:
- Assess hydration status through clinical examination (skin turgor, mucous membranes, orthostatic vital signs) and laboratory markers (BUN/creatinine ratio, urine specific gravity) 1
- Review fluid losses: vomiting, diarrhea, excessive sweating, inadequate fluid intake 1
- Evaluate for volume depletion states: diuretic overuse, diabetes insipidus, or other causes of dehydration 1
Treatment Strategy
Rehydration with appropriate fluids (oral or intravenous) will normalize albumin levels by restoring plasma volume:
- Oral rehydration for mild cases with intact gastrointestinal function 1
- Intravenous crystalloid solutions for moderate to severe dehydration 1
- Monitor response with repeat albumin levels and clinical assessment 1
Important Caveat
If you are asking about elevated urinary albumin (albuminuria) rather than serum albumin, this is an entirely different clinical entity requiring specific treatment as outlined in diabetes and kidney disease guidelines 4, 5. Albuminuria represents kidney damage and requires ACE inhibitors or ARBs for patients with diabetes and urinary albumin excretion ≥30 mg/24h 4, 5.