Use and abuse of albumin and plasma protein infusions in chronic protein depletion

Abstract

Chronic protein depletion is mostly reflected in hypoproteinemia. All protein fractions can be reduced but a decreased serum albumin level, which forms the bulk of serum protein, is most prominent. This depressed serum albumin concentration can be the result of 1) an impaired synthesis; 2) an increased loss or degradation; 3) an altered distribution or 4) a combination of factors (1). Albumin has proved to be not essential to human life since patients with analbuminemia are without important symptoms (2). The functions of albumin are firstly to maintain plasma colloid osmotic pressure and secondly to bind and to transport several substances like metals, ions, fatty acids, drugs, hormones, bilirubin, metabolites, etc. (3). Hypoalbuminemia is not a disease in itself, but like for example a raised E.S.R., fever or weight loss, merely a symptom of a disease. Symptoms of a disease should only be treated if they are dangerous or troublesome to the patient. Obviously, the underlying disorder has to be treated as vigorously as possible. A favorable effect of such a treatment will often be reflected in increasing serum albumin levels.