hypoalbuminaemia

Introduction

hypoalbuminaemia is often a marker of general illness and is associated with higher morbidity and mortality rates
albumin is a negative acute phase reactant in that serum levels FALL during acute inflammatory responses
albumin is a highly water-soluble protein, located mainly in the extra-cellular space, with a total body pool of approximately 300 g (3.5 to 5.3 g/kg) in a normal average man
albumin has a half-life of approximately 20 days
serum albumen levels are determined by the net reult of:
- rate of synthesis by the liver
  - reduced due to:
    - long term protein malnutrition
    - hepatic disease such as cirrhosis which results in ascites
    - inflammatory disease
- rate of breakdown
  - increase rate of breakdown during inflammation or liver disease
- body pool size
  - hence short term reduced protein intake is unlikely to decrease levels due to the relatively low turnover rate (long half life) and the large pool size
- volume of distribution
- exchange between intravascular and extravascular spaces
  - concentrations may actually increase during short-term fasting because of contraction of the intravascular space
- losses from the body
  - renal as in nephrotic syndrome
  - large area burns