Albumin Dialysis

Albumin-binding function is reduced in patients with decompensated cirrhosis and correlates inversely with severity of liver disease assessed by model for end-stage liver disease.

Eur J Gastroenterol Hepatol. 2007 Mar;19(3):257-63.

Klammt S, Mitzner S, Stange J, Brinkmann B, Drewelow B, Emmrich J, Liebe S, Schmidt R.

Divisions of aNephrology bGastroenterology, Department of Internal Medicine, University Rostock cInstitute of Clinical Pharmacology, Center of Pharmacology and Toxicology, University Rostock, Rostock, Germany.

BACKGROUND: Human serum albumin has multiple functions, the most important being maintaining colloid osmotic pressure, ligand binding and transport. In liver failure, an impaired binding of endogenous substances and drugs can be observed. 

The aim of this study was to investigate the relationship between the severity of liver disease and an impaired albumin binding. METHODS: In 44 patients with decompensated liver cirrhosis, Child-Turcotte-Pugh and model for end-stage liver disease scores were assessed and the site II-specific albumin-binding function (albumin-binding capacity) was characterized. Briefly, the unbound amount of diazepam site ligand Dansylsarcosine in a sample was determined and compared with the unbound amount in a reference albumin solution (=100%). RESULTS: Thirty-two out of 44 of the patients presented with Child-Turcotte-Pugh class C, the median Child-Turcotte-Pugh score was 10 [6-13 (min-max)], median model for end-stage liver disease score was 21 (8-40) and the median albumin-binding capacity was 63 (24-91)% compared with healthy controls 98 (95-106)% (P<0.001). Albumin-binding capacity was found to be strongly correlated to model for end-stage liver disease (r=0.783; P<0.001). CONCLUSIONS: An impaired albumin-binding function of a site II-specific marker in decompensated liver cirrhosis was found to be correlated to the severity of the liver disease.

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