Serum albumin concentrations

J. Serum albumin concentration T Vd protein-bounde drugs... 

Figure 34 Effective cell partition coefficient of PNU-78,517 as a function of bovine serum albumin concentration. The inset shows the relationship between the effective permeability coefficient (Pe) of appearance and BSA concentration or the fraction of free drug. These data were obtained from the uptake data shown in Figure 33. [Redrawn from Raub et al. (1993) with permission from the publisher.]...

Weight and serum albumin concentration have the best correlation with clinical outcome the cost-effectiveness of other biochemical parameters is not known. 

Each 1 g/dL drop in serum albumin concentration below 4 g/dL decreases total serum calcium concentration by 0.8 mg/dL. 

Fig. 41. LS plots for solutions of bovine serum albumin (concentration c2) in aq. 6 M guanidine hydrochloride, obtained at constant molarity C3, constant chemical potential n3 and constant molality m3 of guanidine hydrochloride. The resultant molecular weights yielded for this sample are given above each plot15)...

Fig. 44. LS plots142) for bovine serum albumin in iso-ionic salt free aqueous solution [plot (b)]. Also shown are data (open circles) for solution in 0.001 M NaCl [plot (c). Plot (a) is for same data as in (b) plotted against the square root of the bovine serum albumin concentration, c2, according to Eq. (94)...

Plasma volume has been observed to decrease an average of 12% when recumbent individuals arose (F2). The effeet was particularly acute in patients with edema or low serum albumin concentrations (F2). In this study subjects were maintained in bed for 12 hours, a blood specimen was taken after 1 hour in a completely flat position and after 1 hour of walking activity. It was found that after walking the protein values rose 10% in normal persons and 10-15% in patients with edema. The average increase in albumin was 0.48 g/100 ml (F2). 

There are small changes in serum albumin concentration with age, with concomitant small effects on protein binding of some highly bound drugs such as naproxen, salicylate, and warfarin. For such drugs the free concentration rather than the total plasma concentration is a better predictor of drug dose requirements, particularly for drugs with low therapeutic index (difference between the therapeutic... 

Alternatively, ionized calcium can be estimated using the following rule Total serum calcium will fall by 0,8 mg/dl for each 1,0 g/dl decrease in serum albumin concentration... 

The association between low serum albumin concentrations and complications of prednisone has been long recognized, and it is an elementary pharmacokinetic principle that concentrations of unbound drug in plasma (the fraction that can reach the tissues) will be increased when binding of a drug to serum albumin is reduced (413). 

Greenblatt, D.J., Reduced serum albumin concentration in the elderly A report from the Boston Collaborative Drug Surveillance Program, J. Am. Geriatr. Soc., 27, 20,1979. 

Over 20,000 samples of microbial culture broths were subjected to our screening program for CETP inhibitors by method A. At first no BSA was added to the assay mixture, but many false-positive compounds such as fatty acids were isolated. To prevent this, the optimal concentration of BSA was tested and set up as 200 pM, resulting in a low hit rate in the primary screen. The serum albumin concentration in the assay is similar to that in human plasma. Finally, we discovered erabulenols from a fungal strain, and ferroverdins from an actinomycete strain, as novel CETP inhibitors (Fig. 5). 

Figure 4.7 clearly indicates that up to 20 pM BSA, recorded ODs are linearly proportional to serum albumin concentrations. Thus, we can use the standard curve to determine the /3-galactosidase concentration ... 

Figure 4.7 Optical density of Coomassie Blue as a function of serum albumin concentrations.

ECF calcium is moderately bound to plasma proteins (46%), primarily albumin. Unbound or ionized calcium is the physiologically active form. Each 1 g/dL drop in serum albumin concentration below 4 g/dL decreases total serum calcium concentration by 0.8 mg/dL. 

Child-Pugh clinical classification scheme (Table 7.5). Serum albumin concentrations were of greatest predictive value for two of the drugs shown in the table. However, this marker was not correlated with the hepatic clearance of lansoprazole, and a combination of all three laboratory tests was better correlated with hepatic clearance of atorvastatin than was serum albumin alone. Serum concentrations of aspartate aminotransferase (AST) or alanine transaminase (ALT) were not correlated with hepatic drug clearance, as might be expected from the fact that these enzymes reflect hepatocellular damage rather than hepatocellular function. 

The incidence of viral resistance to lamivudine increases with the duration of therapy in patients with chronic hepatitis B (11). However, the effect of viral resistance on hepatic synthetic function has not been well defined. In 38 patients (26 with cirrhosis) in an open study there was an initial antiviral response in all patients (hepatitis B virus DNA became undetectable by a hybridization assay), and nine of 22 (41%) hepatitis B e antigen-positive patients underwent hepatitis B e antigen seroconversion. In 29 patients with undetectable serum hepatitis B viral DNA at the end of the study, the mean serum albumin concentration rose from 40 to 43 g/1, corresponding to a yearly increase of 1.85 g/1 this was largely attributable to an increase in the cirrhotic patients. Resistance to lamivudine developed in nine patients. Suppression of viral replication by lamivudine improves hepatic synthetic function in chronic hepatitis B patients, but emergence of drug resistance is associated with a rapid fall in serum albumin. 

Table 3.7 Pharmacokinetic parameters (mean + SEM) describing the disposition of antipyrine and indocyanine green in healthy human subjects (n = 6) and in patients (n = 9) with chronic liver disease (serum albumin concentration <3g/dL).

Owen WF, Lew NL, Liu Y, Lowrie EG, Lazarus JM. The urea reduction ratio and serum albumin concentration as predictors of mortality in patients undergoing hemodialysis. N Engl J Med 1993 329 1001-6. 

The administration of total parenteral nutrition for periods greater than 1 week induces cholestatic changes and nonspecific enzyme elevations in some patients. Patients with low serum albumin concentrations may be at greater risk than patients with normal serum albumin concentrations. This reaction also has been reported to occur rarely with sulfonamides, sulfonylureas, erythromycin estolate and ethylsuccinate, captopril, fisinoprU, and other phenothiazines. ... 

Alb, serum albumin concentration (g/dL) CLcr, creatinine clearance in mL/min IBW, ideal body weight (kg) Scr, serum or plasma creatinine (mg/dL) SUN, serum urea nitrogen concentration (mg/dL). 

AAP alanine aminopeptidase ABW actual body weight ACE angiotensin-converting enzyme Alb serum albumin concentration AP alkaline phosphatase... 

Edema formation in patients with nephrotic syndrome is primarily related to renal sodium and water retention. A decrease in capillary oncotic pressure does not appear to play a major role until the serum albumin concentration falls to less than 2 g/dL. This is explained by the fact that both capfllary and interstitial oncotic pressure decrease proportionately above a serum albumin concentration of 2 g/dL, and thus the transcapUlary oncotic gradient is not significantly altered. ... 

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