Hypoalbuminemia: Causes, Symptoms, Treatment, Prognosis

What is Hypoalbuminemia?

Hypoalbuminemia is a condition that occurs when a person has abnormally low levels of albumin in the body. A major portion of blood plasma is made up of albumin. It is the blood plasma that holds the proteins and blood cells together. Some of the other functions of albumin are to maintain adequate pressure in the blood vessels and it also facilitates transportation of hormones and medications throughout the body. Albumin binds into various drugs and hormones easily which makes it easier for them to travel within the body. [1, 2, 3]

Thus if the albumin levels in the body goes below a certain level, the blood is unable to transport medications, hormones, or other vital materials in the body.

Hypoalbuminemia is believed to be quite prevalent in the critically ill or hospitalized people. The primary cause for this condition is believed to be either decreased production of this protein which is quite rare or excessive loss of it through the kidneys, gastrointestinal tract, or skin or a combination of the two. [1, 2, 3]

What Causes Hypoalbuminemia?

A person is said to have Hypoalbuminemia if the albumin levels in the body falls below 3.4 g/dL. There are believed to be a variety of reasons as to why someone develops Hypoalbuminemia and accurate knowledge of the cause is extremely important for effective treatment of this condition. The most common causes for Hypoalbuminemia include [3]

Liver Failure: Albumin is produced in the liver. Thus if an individual has liver failure then production of albumin automatically decreases. In fact, the level of albumin is one of the tests that are done to check the function of the liver. Liver failure can be caused due to cancer of the liver, cirrhosis, hepatitis, chronic alcohol abuse, and fatty liver disease. [3]

Acute Heart Failure: This condition also affects the production of albumin in the body. It has been seen that people with a known diagnosis of Acute Heart Failure often have Hypoalbuminemia. Why does this happen is something which researchers are not sure of. [3]

Kidney Dysfunction: Any issue with renal function will cause the kidneys to release increased amounts of protein into the urine. These proteins on their way bind with albumin in the blood and take them it with them causing Hypoalbuminemia. [3]

Gastrointestinal Disorders: Medical conditions like celiac disease or inflammatory bowel disease also causes significant protein loss. This is medically referred to as protein losing enteropathy. These proteins again bind the albumin from the blood causing Hypoalbuminemia. [3]

Malnutrition: Inadequate intake of food rich in nutrients or medical conditions which make it difficult for the body to absorb nutrients from the food all are primary reasons for malnutrition resulting in Hypoalbuminemia. Malnourishment may also be seen in some people undergoing chemotherapy for certain forms of cancer. [3]

Other Causes: Aside from the ones mentioned above, Hypoalbuminemia can also be caused due to significant burn injuries, sepsis, allergic reactions, and autoimmune conditions like lupus or hypothyroidism. Some people with diabetes also end up having Hypoalbuminemia. [3]

What are the Symptoms of Hypoalbuminemia?

The symptoms seen with Hypoalbuminemia are quite variable of which the most common are confusion, dizziness, and fatigue. These people will have excess protein seen on a routine urinalysis. Fluid retention is quite common in people with Hypoalbuminemia which causes swelling of the hands and feet. As a result of Hypoalbuminemia caused due to liver problems the person will have signs of jaundice with yellowing of the eyes and skin. [3]

Other symptoms of Hypoalbuminemia include tachycardia, vomiting, nausea, diarrhea, appetite changes, loss or thinning of hairs, and extremely dry skin that will constantly itch. The symptoms seen with Hypoalbuminemia are similar to many other medical conditions and thus it is literally impossible for an accurate diagnosis based on symptoms alone. [3]

How is Hypoalbuminemia Treated?

Identifying and addressing the underlying cause is the best possible way to treat Hypoalbuminemia. This may be done in the form of intravenous medications that increase albumin levels. Other treatment options include antihypertensives in cases where kidney disease or heart failure is believed to be the cause of Hypoalbuminemia. People with liver dysfunction will have to completely abstain from alcohol to prevent further decline of albumin levels. The patient may also benefit from medications to deal with GI disorders to normalize the albumin levels. [3]

In cases where a burn injury is the cause of Hypoalbuminemia then the patient will be given a course of antibiotics. People with Hypoalbuminemia will have to undergo significant dietary modifications, especially if they are found to have severe renal dysfunction or heart problem. [3]

In rare cases, if a person develops Hypoalbuminemia due to organ failure then transplantation is the preferred route to normalize the levels of albumin. This is seen especially in people with chronic kidney or liver diseases. A person with Hypoalbuminemia will have to hospitalized and closely observed for any complications while undergoing treatment till the time the levels get back to normal. [3]

What Is The Prognosis Of Hypoalbuminemia?

It is the cause of Hypoalbuminemia that determines the overall prognosis for the patient. A prompt and accurate diagnosis of the cause and addressing it promptly can significantly improve the outlook of a person with Hypoalbuminemia. In fact, a timely treatment can prevent life threatening complications. There are some studies which have mentioned that the prognosis of people who need to be hospitalized due to Hypoalbuminemia have a worse prognosis that people who do not need hospitalization. [3]

The study done in 2014 followed 5,500 people who had their albumin levels tested after presentation to the emergency room. It was observed that people with Hypoalbuminemia were much older in age and were required to stay in the hospital for a longer period of time than others. [3]

It was observed that around 17% of people with Hypoalbuminemia succumbed within a month compared to only 4% who had normal albumin levels. This further asserted the fact that identifying the cause of Hypoalbuminemia and giving prompt treatment is vital for a good prognosis for Hypoalbuminemia in an inpatient setting. [3]

In conclusion, Hypoalbuminemia is a condition caused when the body has abnormally low levels of albumin. This protein is vital for the body as it helps transfer hormones and medications in the body and also maintains pressure in the blood vessels. Hypoalbuminemia generally indicates an underlying medical condition, especially problems with the kidney or liver. Heart failure and gastrointestinal disorders like celiac disease have also been shown to cause Hypoalbuminemia. [1, 2, 3]

The symptoms of this condition are similar to a variety of other medical conditions and thus making an accurate diagnosis is quite tough. However, correct diagnosis is absolutely necessary for the treatment to be successful for Hypoalbuminemia. The treatment depends on the underlying cause and includes medications, dietary changes, and lifestyle modifications. [1, 2, 3]

If a person suspects that he or she may have symptoms that might potentially indicate low levels of albumin in the body then it is better to get checked up with a physician to rule out Hypoalbuminemia and the underlying cause of it. It should be noted here that low albumin levels can be reversed if the cause is addressed and the patient adheres strictly to the recommendations provided by the physician. Any delay in treatment can result in potentially serious complications as a result of Hypoalbuminemia. [1, 2, 3]

References:

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