Which conditions commonly cause hypoalbuminemia and what clinical consequence does it have?

• A. Edema due to dehydration and increased oncotic pressure.
• B. Malnutrition, liver disease, nephrotic syndrome, and inflammation; edema due to reduced oncotic pressure.
• C. Hyperalbuminemia from dehydration.
• D. Increased albumin production by the liver.

Answer: (B)

Albumin sustains plasma oncotic pressure, keeping fluid within the vessels. When albumin levels fall, fluid leaks into the interstitial spaces, producing edema and can lead to ascites or pleural effusions in more severe cases. Hypoalbuminemia commonly results from reduced synthesis or increased losses: malnutrition and liver disease lower production; nephrotic syndrome causes loss of albumin in the urine; and inflammation lowers hepatic albumin synthesis and can increase capillary permeability. The key clinical consequence is edema due to decreased oncotic pressure. Dehydration, in contrast, tends to concentrate albumin and raise, not lower, its levels, while excessive liver production would raise albumin rather than cause hypoalbuminemia.