Albumin: Not Just a Plasma Expander

HUMAN SERUM ALBUMIN is important for health and normal metabolic function. It comprises over half of the extracellular protein in blood and is the main regulator of plasma oncotic pressure. Traditionally, its main use has been as a volume expansion agent. Albumin undertakes a wide variety of transport functions and is essential for carrying metabolic products to the liver for metabolism and excretion. Due to its redox-active properties, it also acts as a first line of defence against pro-oxidant and free radical injury. In subjects with liver disease its concentration is reduced, an effect that is further compounded by studies that demonstrate that the remaining protein is functionally impaired. This lack of metabolic function most likely contributes to exacerbation of the disease processes. Administration of albumin to both patients with liver disease, and for a wide variety of other indications, shows beneficial effects that go far beyond simple fluid resuscitation.

Davies NA, Garcia R, Proven A, Jalan R

Gerbes AL (ed): Ascites, Hyponatremia and Hepatorenal Syndrome: Progress in Treatment. Front Gastrointest Res. Basel, Karger, 2011, vol 28, pp 40–51 (DOI: 10.1159/000319177