134 % ( pooled odds ratio , OR = 2.34 , 95 % CI 1.74 – 3.14 ). In addition , among those patients who developed AKI due to hypoalbuminaemia , the odds of death were also increased by 147 % ( OR = 2.47 ), for the same reduction in serum albumin levels .
In a retrospective analysis of 5168 consecutive patients undergoing coronary artery bypass grafting , Engelman et al observed that a low serum albumin level (< 25g / l ) was independently associated with two-fold increased mortality risk ( OR = 2 , 95 % CI 1.3 – 3.0 ) and renal failure ( OR = 2 ). 7
In a systematic review of studies examining the relationship between serum albumin and cancer survival , Gupta and Lis identified that in studies of gastrointestinal , lung , breast and multiple site cancer , low serum albumin levels were associated with a higher incidence of cancer mortality . 8
Albumin in the management of severe liver diseases Viral hepatitis is the leading aetiology for chronic liver disease in Asia . However , improved prevention strategies through government-initiated vaccination programmes for hepatitis B and wide-ranging treatment for hepatitis C show a decline in mortality and morbidity over 30 years . However , alcohol consumption , obesity and diabetes mellitus are issues of concern . 9
Cirrhosis is a prolonged asymptomatic period of persistent liver inflammation , leading to collagen deposition and remodelling of the extracellular matrix . This condition alters the hepatic milieu , leading to liver-related mortality . Advanced / decompensated cirrhosis is associated with a decrease in plasma albumin . Patients with cirrhosis have impaired hepatocellular function and reduced albumin synthesis , which can reach a 60 – 80 % reduction in advanced
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