- Albumin comprises 75-80% of normal plasma colloid oncotic pressure and 50% of protein content. When plasma proteins, especially albumin, no longer sustain sufficient colloid osmotic pressure to counterbalance hydrostatic pressure, edema develops.
- Albumin transports various substances, including bilirubin, fatty acids, metals, ions, hormones, and exogenous drugs. One consequence of hypoalbuminemia is that drugs that are usually protein bound are free in the plasma, allowing for higher drug levels, more rapid hepatic metabolism, or both.
- Alterations in albumin level affect platelet function.
Race: No race predilection exists.
Sex: No sex predilection exists.
Age: Hypoalbuminemia affects persons of all age groups, depending on the underlying cause.
Treatment
Medical Care: Treatment should focus on the underlying cause of hypoalbuminemia.
Treatment
Medical Care: Treatment should focus on the underlying cause of hypoalbuminemia.
- In patients who are critically ill, low calcium levels can be simply due to hypoalbuminemia, which has no clinical significance because the active fraction (ionized) is not affected. However, to prevent missing a second hypocalcemic disorder, measure the ionized calcium level whenever the albumin level is low.
Surgical Care: Surgery is considered only when indicated for the underlying cause.
Consultations: Depending on the clinical situation, multiple consultations may be necessary.
- Gastroenterologist
- Intensivist
- Nephrologist
- Surgeon
- Endocrinologist
- Registered dietitian
Diet: Support the underlying cause with adequate nutrition (sufficient high biological value protein and energy intake for anabolism).
Activity: Recommendations depend on the severity of the underlying disease.
Medication
Hypoalbuminemia is a common phenomenon in patients with serious illness. Treatment should focus on the underlying cause rather than simply replacing albumin. Results of several meta-analyses of albumin treatment in hospitalized patients have been inconsistent. A 1998 Cochrane meta-analysis found that albumin treatment increased mortality; these findings were not confirmed by the meta-analysis of Wilkes et al (2001), which found no overall effect of albumin on mortality. The SAFE study investigators found no difference in survival between albumin and saline administration for hypovolemic ICU patients. Vincent reviewed albumin's effect on morbidity in a 2004 meta-analysis; this study found albumin favorably affected morbidity in hypoalbuminemic hospitalized patients. Limited indications for albumin supplementation exist, and considerable clinical judgment is required when albumin is administered. However, in general, albumin is not given specifically to treat hypoalbuminemia, which is a marker for serious disease.
Medication
Hypoalbuminemia is a common phenomenon in patients with serious illness. Treatment should focus on the underlying cause rather than simply replacing albumin. Results of several meta-analyses of albumin treatment in hospitalized patients have been inconsistent. A 1998 Cochrane meta-analysis found that albumin treatment increased mortality; these findings were not confirmed by the meta-analysis of Wilkes et al (2001), which found no overall effect of albumin on mortality. The SAFE study investigators found no difference in survival between albumin and saline administration for hypovolemic ICU patients. Vincent reviewed albumin's effect on morbidity in a 2004 meta-analysis; this study found albumin favorably affected morbidity in hypoalbuminemic hospitalized patients. Limited indications for albumin supplementation exist, and considerable clinical judgment is required when albumin is administered. However, in general, albumin is not given specifically to treat hypoalbuminemia, which is a marker for serious disease.