Index
This disease can be caused by decreased production, increase or loss, redistribution, or dilution of albumin in the blood.
Hypoalbuminemia is a common phenomenon in patients with severe diseases. The treatment should focus on the underlying cause rather than the simple albumin replacement.
Hypoalbuminemia is a common finding in critically ill patients who are hospitalized. When the disease leads to moderate or severe hypoalbuminemia (i.e., albumin <2 mg/dl), detrimental consequences can influence the clinical course and negatively impact patients’ life and health prognosis.
Several human studies and a few veterinarians have shown that hypoalbuminemia correlates with a poorer prognosis. Treatment considerations for patients should address the consequences and causes of hypoalbuminemia.
Its causes?
They can be divided into four general categories: decreased albumin synthesis, loss of albumin, redistribution of albumin to places outside the intravascular space, and dilution of albumin within the intravascular space. The cause of hypoalbuminemia in a particular patient is often multifactorial.
For patients with hypoalbuminemia and critical illness, albumin administration has not been shown to reduce mortality.
Which is the treatment?
There are limited indications for albumin supplementation, and considerable clinical judgment is required when albumin is administered.
Albumin has been used as a part of regimens designed to prevent hepatorenal syndrome in patients with cirrhosis; however, this is controversial, and the benefit in survival has not been established.
In general, albumin is not explicitly given to treat hypoalbuminemia, a marker of severe disease.
Considering fluid resuscitation more generally, recent research found that 6% of hydroxyethyl starch used for resuscitation in patients with severe sepsis was associated with a significant increase in acute renal failure, calling this approach in question.
The most effective method of minimizing hypoalbuminemia and restoring oncotic pressure is by creating a positive nitrogen balance. This is usually achieved by enteral protein feeding and reversing the inflammatory state, if present.
