Low albumin

Hypoalbuminaemia results in oedema and effects secondary to the decreased transport of specific molecules, e.g. calcium.

Congenital:

• analbuminaemia - rare; plasma albumin usually less than 1.0 g/l. Often asymptomatic due to compensatory increases in plasma globulins.

Reduced synthesis:

• liver disease - usually only in chronic disease as:
  • large hepatic reserve
  • long half-life of albumin - 20 days
• severe malnutrition

Increased catabolism:

• following trauma, surgery
• infection
• malignancy

Increased losses:

• renal - proteinuria, especially the nephrotic syndrome
• skin - exfoliative dermatitis; severe burns
• gastrointestinal tract:
  • haemorrhage
  • protein losing enteropathies

Altered distribution:

• serous effusion, e.g. ascites
• overhydration