The liver produces albumin and then secretes into the bloodstream, where it is then distributed into tissues across the body. In the liver, the liver synthesizes albumin as pre-proalbumin, converts it first into proalbumin and then albumin in hepatocytes, and releases it into the blood. The body synthesizes albumin at a rate of 10 to 15 grams per day. In the presence of<unk> , the liver can increase production by as much as four times the baseline production rate. Once released, albumin distributes itself between the intravascular space (40%) in blood vessels, and extravascular spaces (60%) within the body's different tissues. In the blood plasma, albumin makes up 55 to 60% of total plasma protein by mass, with globulins making up a large part of the rest. In<unk> , the amount of albumin in the intravascular space or blood plasma is what is being measured, meaning that abnormal distribution within the two compartments may contribute to a relative<unk>  in the bloodstream with a normal level in the whole body. Once released into the body, albumin performs a number of functions that can be negatively affected by the reduced levels seen in<unk> . These functions include regulation of colloid osmotic pressure or protein concentration within the blood plasma, transport of free fatty acids and other molecules to the liver (unconjugated bilirubin, metals, ions) for storage or utilization, binding of drugs and alteration of pharmacokinetics (half-life, biological activity levels, metabolism), buffering plasma pH, scavenging reactive oxygen species to avoid inflammation and associated damage, functioning as a reservoir of nitric oxide for the regulation of blood pressure, and prevention of coagulation and platelet aggregation in an action similar to the commonly used anticoagulant heparin. It also inhibits inflammatory mediators such as TNF-α and complement 5a (C5a) to reduce the overall inflammatory response. A number of hormones (e.g. thyroxine, cortisol, testosterone), drugs, and other molecules are bound to albumin in the bloodstream and must be released from albumin before becoming biologically active. For example, calcium binds to albumin; in<unk> , there is an increased amount of free ionized calcium, its biologically active form. In the presence of<unk> , these functions are differentially affected, and the mechanisms by which they affect disease outcomes remains an area of active debate.
Hypoalbuminemia
Bisalbuminemia
Albuminuria
Proteinuria
Proteinopathy
Bilirubinuria
Renal glycosuria
Lipiduria