Hypoalbuminemi

Hypoalbuminemia is a medical condition characterized by lower-than-normal levels of albumin in the blood. In adults, serum albumin below about 3.5 g/dL (35 g/L) is commonly used to define hypoalbuminemia. Albumin, the main protein synthesized by the liver, helps maintain oncotic pressure and serves as a carrier for various substances.

Causes of hypoalbuminemia are diverse and usually fall into three broad categories: decreased synthesis, increased loss, and increased catabolism or redistribution. Decreased synthesis occurs with liver diseases such as cirrhosis or severe malnutrition and protein-energy wasting, often in the setting of chronic inflammation. Increased loss is typical in nephrotic syndrome, extensive burns, or protein-losing enteropathies. Redistribution or enhanced catabolism can occur during acute illness or sepsis, and inflammatory states can suppress albumin production despite adequate intake.

Clinical features commonly include edema, which may be peripheral or peritoneal (ascites), and sometimes weight gain. Additional signs depend on the underlying cause and may include fatigue, jaundice, or signs of malnutrition. Low albumin can affect the pharmacokinetics of drugs due to reduced binding and altered distribution.

Diagnosis involves measuring serum albumin and evaluating potential causes: liver function tests, renal assessments (including proteinuria), nutritional status, and assessments for inflammatory or infectious processes. Identifying the underlying disorder is essential for management.

Treatment focuses on addressing the root cause, along with nutritional support and fluid management. In selected cases, such as certain cirrhosis-related scenarios or after large-volume paracentesis, albumin infusions may be used. The prognosis of hypoalbuminemia depends largely on the associated condition and overall health.