What is the role of chronic inflammation in the etiology of hypoalbuminemia?

Updated: Sep 11, 2020
  • Author: Ruben Peralta, MD, FACS; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Albumin levels that are low because of acute inflammation should normalize within weeks of resolution of the inflammation. Persistent hypoalbuminemia beyond this point should prompt an investigation for an ongoing inflammatory process. The cytokines (TNF, IL-6) released as part of the inflammatory response to physiologic stress (infection, surgery, trauma) can decrease serum albumin by the following mechanisms:

  • Increased vascular permeability (allowing albumin to diffuse into the extravascular space)

  • Increased degradation

  • Decreased synthesis (among other mechanisms, by activating TNF-a, which decreases transcription of the albumin gene)

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