Summary: A condition in which albumin level in blood (SERUM ALBUMIN) is below the normal range. Hypoalbuminemia may be due to decreased hepatic albumin synthesis, increased albumin catabolism, altered albumin distribution, or albumin loss through the urine (ALBUMINURIA).

Top Publications

  1. Cooper B, Penne E, Bartlett L, Pollock C. Protein malnutrition and hypoalbuminemia as predictors of vascular events and mortality in ESRD. Am J Kidney Dis. 2004;43:61-6 pubmed
    ..However, previous studies were unable to differentiate between true protein malnutrition and hypoalbuminemia. This study was undertaken to determine the associations between malnutrition, measured by total-body ..
  2. Xue P, Huang Z, Li Y, Guo J, Wang Z, Zhao J, et al. [Clinical study on severe acute pancreatitis associated with hypoalbuminemia in early stage]. Zhong Xi Yi Jie He Xue Bao. 2005;3:443-5 pubmed
    ..the occurring mechanism and clinical characteristics of severe acute pancreatitis (SAP) associated with hypoalbuminemia in early stage and its influence on prognosis of SAP and the preventive and therapeutic management of this ..
  3. Dubois M, Orellana Jimenez C, Melot C, De Backer D, Berre J, Leeman M, et al. Albumin administration improves organ function in critically ill hypoalbuminemic patients: A prospective, randomized, controlled, pilot study. Crit Care Med. 2006;34:2536-40 pubmed
    To test the hypothesis that administration of albumin to correct hypoalbuminemia might have beneficial effects on organ function in a mixed population of critically ill patients. : Prospective, controlled, randomized study...
  4. Wiedermann C, Wiedermann W, Joannidis M. Hypoalbuminemia and acute kidney injury: a meta-analysis of observational clinical studies. Intensive Care Med. 2010;36:1657-65 pubmed publisher
    To test the hypothesis that hypoalbuminemia is independently associated with increased risk of acute kidney injury (AKI)...
  5. Ddungu H, Johnson J, Smieja M, Mayanja Kizza H. Digital clubbing in tuberculosis--relationship to HIV infection, extent of disease and hypoalbuminemia. BMC Infect Dis. 2006;6:45 pubmed
    ..Smear grade, extensive or cavitary disease, early versus late HIV disease, and hypoalbuminemia were not associated with clubbing...
  6. Joki N, Hase H, Tanaka Y, Takahashi Y, Saijyo T, Ishikawa H, et al. Relationship between serum albumin level before initiating haemodialysis and angiographic severity of coronary atherosclerosis in end-stage renal disease patients. Nephrol Dial Transplant. 2006;21:1633-9 pubmed
    ..It may reflect mainly a state of inflammation. However, malnutrition as a confounding factor cannot be entirely excluded. ..
  7. Kotoh K, Nakamuta M, Fukushima M, Matsuzaki C, Enjoji M, Sakai H, et al. High relative fat-free mass is important for maintaining serum albumin levels in patients with compensated liver cirrhosis. World J Gastroenterol. 2005;11:1356-60 pubmed
    In patients with liver cirrhosis, hypoalbuminemia causes edema and ascites, and a reduction in the quality of life...
  8. Caridi G, Dagnino M, Di Duca M, Pinto H, Espinheira M, Guerra A, et al. A novel splicing mutation causes analbuminemia in a Portuguese boy. Mol Genet Metab. 2012;105:479-83 pubmed publisher
    ..DNA and cDNA sequence analysis established the diagnosis of congenital analbuminemia in the proband. The effects of the so far identified splice-site mutations in the albumin gene are discussed. ..
  9. Bibi A, Jouini L, Sahli C, Hadj Fredj S, Abidi K, Gharsallah L, et al. Detection of a novel splicing mutation causing analbuminemia in a Libyan family. Clin Biochem. 2012;45:1183-6 pubmed publisher
    ..Molecular diagnosis based on DHPLC and DNA sequencing represents a powerful tool to study molecular defects causing analbuminemia. ..

More Information


  1. Farrugia A. Albumin usage in clinical medicine: tradition or therapeutic?. Transfus Med Rev. 2010;24:53-63 pubmed publisher
    ..More clinical investigations of albumin's therapeutic role are needed before its unique biological features can be shown to result in therapeutically useful drugs. ..
  2. Al Tassan N, Khalil D, Shinwari J, Al Sharif L, Bavi P, Abduljaleel Z, et al. A missense mutation in PIK3R5 gene in a family with ataxia and oculomotor apraxia. Hum Mutat. 2012;33:351-4 pubmed publisher
    ..Our characterization of the PIK3R5 protein and findings suggest that it may play a role in the development of the cerebellum and vermis...
  3. Eljaiek R, Dubois M. Hypoalbuminemia in the first 24h of admission is associated with organ dysfunction in burned patients. Burns. 2013;39:113-8 pubmed publisher
    b>Hypoalbuminemia is a common finding in burned patients, but its association with increased morbidity and mortality has not been well established...
  4. Ulldemolins M, Roberts J, Rello J, Paterson D, Lipman J. The effects of hypoalbuminaemia on optimizing antibacterial dosing in critically ill patients. Clin Pharmacokinet. 2011;50:99-110 pubmed publisher
    ..Further research that defines dosing regimens that account for such altered pharmacokinetics is recommended. ..
  5. Bozic M, Howenstine M, Maguiness K, Molleston J. Hypoalbuminemia in a cystic fibrosis patient with severe erosive esophagitis. Nutr Clin Pract. 2010;25:304-7 pubmed publisher
    An 8-year-old patient with cystic fibrosis presented with hypoalbuminemia as the main symptom of severe erosive esophagitis...
  6. Minchiotti L, Galliano M, Kragh Hansen U, Peters T. Mutations and polymorphisms of the gene of the major human blood protein, serum albumin. Hum Mutat. 2008;29:1007-16 pubmed publisher
    ..Allotypes from three of the point mutations become N-glycosylated and one C-terminal frameshift mutation shows O-glycosylation. ..
  7. Shearer G, Kaysen G. Endothelial bound lipoprotein lipase (LpL) depletion in hypoalbuminemia results from decreased endothelial binding, not decreased secretion. Kidney Int. 2006;70:647-53 pubmed
    ..The finding that NS serum alters LpL binding to RAEC suggests LpL depletion results from decreased binding rather than defective delivery. This in turn is a consequence of reduced serum albumin or pi but does not require proteinuria. ..
  8. Lee C, Min I, Hwang J, Kwon K, Lee H. Clinical significance of hypoalbuminemia in outcome of patients with scrub typhus. BMC Infect Dis. 2010;10:216 pubmed publisher
    This study was designed to investigate the clinical significance of hypoalbuminemia as a marker of severity and mortality in patients with Scrub typhus...
  9. Wolf G, McClain C, Zurakowski D, Dodson B, McManus M. Total phenytoin concentrations do not accurately predict free phenytoin concentrations in critically ill children. Pediatr Crit Care Med. 2006;7:434-9; quiz 440 pubmed
    ..Instead, free phenytoin concentrations should be routinely measured in critically ill children to prevent possible intoxications and ensure therapeutic dosing. Corrections using the Sheiner-Tozer equation were unreliable. ..
  10. Li Y, Liu F, Liu Z, Huang Y, Li L, Zhang X, et al. Effect of tacrolimus and cyclosporine A on suppression of albumin secretion induced by inflammatory cytokines in cultured human hepatocytes. Inflamm Res. 2006;55:216-20 pubmed
    ..These findings suggest that IL-6, but not IL- 10, may play an important role in the suppression of hepatic albumin secretion. FK506 but not CSA protects against the suppression of hepatic albumin synthesis caused by IL-6. ..
  11. Lee E, Baek S, Chin J, Choi D, Son H, Kim W, et al. Preoperative hypoalbuminemia is a major risk factor for acute kidney injury following off-pump coronary artery bypass surgery. Intensive Care Med. 2012;38:1478-86 pubmed publisher
    ..Preoperative low serum albumin level is an independent risk factor for AKI, and postoperative AKI is associated with poor outcomes after OPCAB in patients with preoperative normal renal function. ..
  12. Shioya M, Yoshida T, Kasai K, Furuya R, Kato A, Mori N, et al. Inflammatory factors for hypoalbuminemia in Japanese peritoneal dialysis patients. Nephrology (Carlton). 2013;18:539-44 pubmed publisher
    ..Hypoalbuminaemia was attributable to both the increased peritoneal permeability and systemic inflammation, and intraperitoneal inflammation might contribute to developing these complications. ..
  13. Doungngern T, Huckleberry Y, Bloom J, Erstad B. Effect of albumin on diuretic response to furosemide in patients with hypoalbuminemia. Am J Crit Care. 2012;21:280-6 pubmed publisher
    ..Addition of albumin to a furosemide infusion did not enhance diuresis obtained with furosemide alone in critically ill patients. ..
  14. Snyder C, Biggio J, Bartle D, Georgeson K, Muensterer O. Early severe hypoalbuminemia is an independent risk factor for intestinal failure in gastroschisis. Pediatr Surg Int. 2011;27:1155-8 pubmed publisher
    This study attempted to evaluate the association of early hypoalbuminemia with the risk of intestinal failure in gastroschisis patients...
  15. Budagov R, Ul ianova L. [Some consequences of systemic inflammatory response in the pathogenesis of aggravation of outcomes of combined radiation and thermal injuries]. Radiats Biol Radioecol. 2005;45:191-5 pubmed
    ..15th day) was characterized with expressed postradiation leikopenia and thrombocytopenia, was accompanied by hypoalbuminemia and hyperfibrinogenemia with a moderate raise in serum ALT activity...
  16. de la Cruz K, Bakaeen F, Wang X, Huh J, LeMaire S, Coselli J, et al. Hypoalbuminemia and long-term survival after coronary artery bypass: a propensity score analysis. Ann Thorac Surg. 2011;91:671-5 pubmed publisher
    b>Hypoalbuminemia is associated with increased morbidity in surgical patients. The impact of low albumin level on survival in cardiac surgical patients is unknown...
  17. Nisar P, Appau K, Remzi F, Kiran R. Preoperative hypoalbuminemia is associated with adverse outcomes after ileoanal pouch surgery. Inflamm Bowel Dis. 2012;18:1034-41 pubmed publisher
    ..Out of 405 patients, 34 were hypoalbuminemic pre-IPAA. Pre-IPAA hypoalbuminemia was associated with pouch failure (P = 0.004)...
  18. Tumbale P, Appel C, Kraehenbuehl R, Robertson P, Williams J, Krahn J, et al. Structure of an aprataxin-DNA complex with insights into AOA1 neurodegenerative disease. Nat Struct Mol Biol. 2011;18:1189-95 pubmed publisher
  19. Quinzii C, Kattah A, Naini A, Akman H, Mootha V, DiMauro S, et al. Coenzyme Q deficiency and cerebellar ataxia associated with an aprataxin mutation. Neurology. 2005;64:539-41 pubmed
    ..The authors' observations indicate that CoQ10 deficiency may contribute to the pathogenesis of AOA1...
  20. Forrest L, McMillan D, McArdle C, Angerson W, Dunlop D. Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. Br J Cancer. 2004;90:1704-6 pubmed
    ..On multivariate analysis with ECOG, white cell count and the GPS entered as covariates, only the GPS was a significant independent predictor of survival (HR 1.88, 95% CI 1.25-2.84, P=0.002). ..
  21. Ruot B, Papet I, Bechereau F, Denis P, Buffiere C, Gimonet J, et al. Increased albumin plasma efflux contributes to hypoalbuminemia only during early phase of sepsis in rats. Am J Physiol Regul Integr Comp Physiol. 2003;284:R707-13 pubmed
    The mechanisms leading to hypoalbuminemia in sepsis were explored by measuring plasma volume, albumin distribution, plasma albumin transcapillary escape rate (TER), and efflux (TER x albumin intravascular pool)...
  22. Thap L, Supanaranond W, Treeprasertsuk S, Kitvatanachai S, Chinprasatsak S, Phonrat B. Septic shock secondary to scrub typhus: characteristics and complications. Southeast Asian J Trop Med Public Health. 2002;33:780-6 pubmed
    ..and thrombocytopenia; SGOT, ALP, direct bilirubin (DB), total billirubin (TB), BUN, Cr were elevated; hypoalbuminemia was noted. Urinalysis showed that 88.9% of the patients had albuminuria. 77...
  23. Al Shaiba R, McMillan D, Angerson W, Leen E, McArdle C, Horgan P. The relationship between hypoalbuminaemia, tumour volume and the systemic inflammatory response in patients with colorectal liver metastases. Br J Cancer. 2004;91:205-7 pubmed
    ..001) but not percentage hepatic replacement (P=0.34). These results show that hypoalbuminaemia is associated with the presence of a systemic inflammatory response rather than tumour volume in patients with colorectal liver metastases. ..
  24. Don B, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004;17:432-7 pubmed
    b>Hypoalbuminemia is the result of the combined effects of inflammation and inadequate protein and caloric intake in patients with chronic disease such as chronic renal failure...
  25. Forrest L, McMillan D, McArdle C, Angerson W, Dunlop D. Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer. 2003;89:1028-30 pubmed
    ..001) was comparable in prognostic value to that based on stage and performance status (HR 1.48, 95% CI 1.12 - 1.95, P=0.006) in patients with inoperable non-small-cell lung cancer. The former is simple to measure and well standardised. ..
  26. Kim Y, Yoon S, Ku Y, Yang C, Kim Y, Kim S, et al. Serum albumin level correlates with disease severity in patients with Hemorrhagic Fever with Renal Syndrome. J Korean Med Sci. 2003;18:696-700 pubmed
    b>Hypoalbuminemia frequently occurs in Hemorrhagic Fever with Renal Syndrome (HFRS), but clinical significance of hypoalbuminemia is not well known...
  27. Criscuolo C, Mancini P, Saccà F, De Michele G, Monticelli A, Santoro L, et al. Ataxia with oculomotor apraxia type 1 in Southern Italy: late onset and variable phenotype. Neurology. 2004;63:2173-5 pubmed
    ..A novel homozygous missense mutation (H201Q) was found in one patient and a Japanese missense mutation (P206L) in two. AOA1 clinical heterogeneity and onset later than previously described are shown. ..
  28. Amouri R, Moreira M, Zouari M, El Euch G, Barhoumi C, Kefi M, et al. Aprataxin gene mutations in Tunisian families. Neurology. 2004;63:928-9 pubmed
    ..Two novel mutations were identified, the complete deletion of the gene, which seems to not correlate with an increased severity of the disease, and a splice mutation on the acceptor splice site of exon 7...
  29. Danielski M, Ikizler T, McMonagle E, Kane J, Pupim L, Morrow J, et al. Linkage of hypoalbuminemia, inflammation, and oxidative stress in patients receiving maintenance hemodialysis therapy. Am J Kidney Dis. 2003;42:286-94 pubmed
    b>Hypoalbuminemia is a powerful predictor of cardiovascular mortality in maintenance hemodialysis patients...
  30. Suzuki S, Ichikawa Y, Nakagawa K, Kumamoto T, Mori R, Matsuyama R, et al. High infiltration of mast cells positive to tryptase predicts worse outcome following resection of colorectal liver metastases. BMC Cancer. 2015;15:840 pubmed publisher
    ..Multivariate analyses indicated that hypoalbuminemia and high peritumoral MC infiltration were significant predictors of unfavorable OS...
  31. Vischer U, Giannelli S, Weiss L, Perrenoud L, Frangos E, Herrmann F. The prevalence, characteristics and metabolic consequences of renal insufficiency in very old hospitalized diabetic patients. Diabetes Metab. 2011;37:131-8 pubmed publisher
    ..These features must be taken into account when organizing the global care of elderly diabetic patients. ..
  32. Huang S, Chen J, Cheng C, Yang Y. Hypoalbuminaemia is an independent predictor for hemophagocytic lymphohistiocytosis in childhood Epstein-Barr virus-associated infectious mononucleosis. Eur J Haematol. 2012;89:417-22 pubmed publisher
    ..This study aimed to identify commonly available clinical and laboratory predictors that might help clinicians decide to perform the bone marrow and immunological tests for HLH in paediatric EBV-associated IM...
  33. Pata G, Crea N, Di Betta E, Bruni O, Vassallo C, Mittempergher F. Biliopancreatic diversion with transient gastroplasty and duodenal switch: long-term results of a multicentric study. Surgery. 2013;153:413-22 pubmed publisher
    ..One year postoperatively, but absent thereafter, we observed severe hypoalbuminemia (serum albumin <3 g/dL) in 1.7% of patients and severe iron-deficiency anemia in 1.9%...
  34. Okamura K, Nagata N, Kumazoe H, Ikegame S, Wakamatsu K, Kajiki A, et al. Relationship between computed tomography findings and nutritional status in elderly patients with pulmonary tuberculosis. Intern Med. 2011;50:1809-14 pubmed
    ..Age- and gender-adjusted analyses for the nutritional parameters and confounders revealed that hypoalbuminemia, lymphocytopenia, and steroid therapy were significantly related to the presence of atypical CT findings...
  35. Alcázar Lázaro V, del Ser Quijano T, Barba Martín R. Hypoalbuminemia and other prognostic factors of mortality at different time points after ischemic stroke. Nutr Hosp. 2013;28:456-63 pubmed publisher
    The aim of this study was to investigate whether hypoalbuminemia and other risk factors for mortality after stroke have the same or different short (1 month), medium (3 months), long (1 year) or very long term (5 years) prognostic value...
  36. Weerakkody R, Lokuliyana P, Sheriff M. Acute renal failure during immediate post transplant period due to a pericardial effusion. BMC Res Notes. 2015;8:587 pubmed publisher
    ..The exact cause of pericardial effusion is unclear but hypoalbuminemia, drug-induced and idiopathic are possible causes...
  37. Park M, Roh J, Kim S, Choi S, Nam S, Kim S. Prognostic value of circulating biomarker score in advanced-stage head and neck squamous cell carcinoma. Eur J Cancer. 2018;92:69-76 pubmed publisher
    ..Univariate analyses showed that hypoalbuminemia, leucocytosis, C-reactive protein, high CB scores (≥6), age, performance status and comorbidity and tumour ..
  38. Tancredi D, Butani L. Pretransplant serum albumin is an independent predictor of graft failure in pediatric renal transplant recipients. J Pediatr. 2014;164:602-6 pubmed publisher
    To determine the prevalence of hypoalbuminemia in children listed for renal transplantation and to evaluate the effect of pretransplant hypoalbuminemia on posttransplant outcomes...
  39. Al Helal B, Su W, Churchill D, Gangji A. Relative hypoparathyroidism and hypoalbuminemia are associated with hip fracture in hemodialysis patients. Clin Nephrol. 2010;73:88-93 pubmed
    ..Relative hypoparathyroidism and hypoalbuminemia are associated with an increased risk of hip fracture in hemodialysis patients...
  40. Tseng W, Canter R, Bold R. Perioperative outcomes for open distal pancreatectomy: current benchmarks for comparison. J Gastrointest Surg. 2011;15:2053-8 pubmed publisher
    ..Predictors of any complication or severe complication were renal insufficiency, hypoalbuminemia, and worsening ASA classification. Malignant diagnosis was not associated with poorer outcomes...
  41. Verbeek L, Slaghekke F, Hulzebos C, Oepkes D, Walther F, Lopriore E. Hypoalbuminemia in donors with twin anemia-polycythemia sequence: a matched case-control study. Fetal Diagn Ther. 2013;33:241-5 pubmed publisher
    ..e. 4.0 g/l (2.5-10.5) versus 2.0 g/l (1.0-4.0) (p = 0.003). The rate of hypoalbuminemia (<20 g/l) and hypoproteinemia (<40 g/l) in donor twins with TAPS was 20% (5/25) and 32% (8/25)...
  42. Bassyouni I, Fawzi S, Gheita T, Bassyouni R, Nasr A, El Bakry S, et al. Clinical Association of a Soluble Triggering Receptor Expressed on Myeloid Cells-1 (sTREM-1) in Patients with Systemic Lupus Erythematosus. Immunol Invest. 2017;46:38-47 pubmed publisher
    ..e. SLEDAI score, IL-6, hypoalbuminemia. On the other hand, we did not find significant differences in sTREM-1 levels in relation to age, disease ..
  43. Pyzik M, Rath T, Kuo T, Win S, Baker K, HUBBARD J, et al. Hepatic FcRn regulates albumin homeostasis and susceptibility to liver injury. Proc Natl Acad Sci U S A. 2017;114:E2862-E2871 pubmed publisher
    ..Here we demonstrate that mice with global or liver-specific FcRn deletion exhibit hypoalbuminemia, albumin loss into the bile, and increased albumin levels in the hepatocyte...
  44. Megged O, Schlesinger Y. Cytomegalovirus-associated protein-losing gastropathy in childhood. Eur J Pediatr. 2008;167:1217-20 pubmed publisher
    Menetrier's disease is an uncommon disease in childhood, characterized by gastric hypertrophy and hypoalbuminemia secondary to protein loss through the gastric mucosa...
  45. David K, Picus J. Evaluating risk factors for the development of ifosfamide encephalopathy. Am J Clin Oncol. 2005;28:277-80 pubmed
    ..3 g/dL) compared with the control population (3.7 g/dL). The odds ratio of hypoalbuminemia for the development of encephalopathy was calculated as 4.3 (CI, 2.26-8.3)...
  46. Gómez J, Gunnerson K, Song M, Li J, Kellum J. Effects of hypercapnia on BP in hypoalbuminemic and Nagase analbuminemic rats. Chest. 2007;131:1295-300 pubmed
    ..Baseline values for apparent strong ion difference are lower in NA rats consistent with a reduced buffer base resulting from analbuminemia. ..
  47. Miura K, Konishi J, Miyake T, Makita M, Hojo A, Masaki Y, et al. A Host-Dependent Prognostic Model for Elderly Patients with Diffuse Large B-Cell Lymphoma. Oncologist. 2017;22:554-560 pubmed publisher
    ..Treatment in Japan developed a host-dependent prognostic model consisting of higher age (>75 years), hypoalbuminemia (<3.7 g/dL), and higher Charlson Comorbidity Index score (≥3) for such elderly patients...
  48. Vahedi A, Lotfinia I, Sad R, Halimi M, Baybordi H. Relationship between admission hypoalbuminemia and inhospital mortality in acute stroke. Pak J Biol Sci. 2011;14:118-22 pubmed
    This study aims at assessing the relation between hypoalbuminemia and inhospital mortality in patients with acute stroke...
  49. Martin G. A new twist on albumin therapy in the intensive care unit, again. Crit Care Med. 2006;34:2677-9 pubmed
  50. Kotze P, Saab M, Saab B, da Silva Kotze L, Olandoski M, Pinheiro L, et al. Tumor Necrosis Factor Alpha Inhibitors Did Not Influence Postoperative Morbidity After Elective Surgical Resections in Crohn's Disease. Dig Dis Sci. 2017;62:456-464 pubmed publisher
    ..perianal CD, and stomas were considered risk factors for surgical complications, and previous steroids and hypoalbuminemia for medical complications...
  51. Pradel V, Tardieu S, Micallef J, Signoret A, Villano P, Gauthier L, et al. Use of albumin in three French university hospitals: is prescription monitoring still useful in 2004?. Pharmacoepidemiol Drug Saf. 2007;16:79-85 pubmed
    ..The first indications were hypoalbuminemia (33% of total quantity), plasmapheresis (30.2%) and ascites or hepatorenal syndrome (13.7%)...
  52. Hirano M, Matsumura R, Nakamura Y, Saigoh K, Sakamoto H, Ueno S, et al. Unexpectedly mild phenotype in an ataxic family with a two-base deletion in the APTX gene. J Neurol Sci. 2017;378:75-79 pubmed publisher
    Early onset ataxia with ocular motor apraxia and hypoalbuminemia (EAOH)/ataxia with oculomotor apraxia 1 (AOA1) is an autosomal recessive disorder caused by mutations in the APTX gene...
  53. Huang J, Yuan Y, Wang Y, Chen Y, Kong W, Xue W, et al. Preoperative prognostic nutritional index is a significant predictor of survival in patients with localized upper tract urothelial carcinoma after radical nephroureterectomy. Urol Oncol. 2017;35:671.e1-671.e9 pubmed publisher
    ..777 and 0.767 to 0.791 and 0.774, respectively, when PNI added, which was higher than hypoalbuminemia (albumin<37.75g/l) or neutrophil-to-lymphocyte ratio >2.955 added...