Medical Care
Treatment should focus on the underlying cause of hypoalbuminemia. See the Medication section.
To help optimize fluid resuscitation with colloids in patients who are critically ill, volume status may be monitored with a central venous, pulmonary artery catheter or other minimal invasive techniques (see the article Distributive Shock).
In patients who are critically ill, low calcium levels can be simply due to hypoalbuminemia, which has no clinical significance because the active fraction (ionized) is not affected. However, to prevent missing a second hypocalcemic disorder, measure the ionized calcium level whenever the albumin level is low.
In end-stage cirrhosis, albumin infusions decrease the incidence of renal insufficiency and decrease the mortality rate. Furthermore, in the setting of spontaneous bacterial peritonitis, the combination of cephalosporin and albumin markedly increases survivorship, presumably by improving toxin clearance.
Surgical Care
Surgery is considered only when indicated for the underlying cause.
Consultations
Depending on the clinical situation, multiple consultations may be necessary.
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Gastroenterologist
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Intensivist
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Nephrologist
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Surgeon
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Endocrinologist
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Registered dietitian
Diet
Support the underlying cause with adequate nutrition (sufficient high biological value protein and energy intake for anabolism).
Activity
Recommendations depend on the severity of the underlying disease.
Long-Term Monitoring
The significance of hypoalbuminemia appears to be its reflection of the severity of the underlying disease process. Therefore, follow-up care, in both inpatient and outpatient settings, is dictated by those processes.
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Albumin.
