Reciprocal Relation between Plasma Albumin Level and Hepatic Sulfobromophthalein Removal

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Abstract
In four patients with hypoalbuminemia due to the nephrotic syndrome, the removal rate of sulfobromophthalein (BSP) was rapid with less than 1 per cent dye retention at 45 minutes. After partial correction of the hypoalbuminemia by intravenous infusion of salt-poor human albumin, dye retention was 4 to 9 per cent at 45 minutes. This reciprocal relation between BSP removal rate and plasma albumin level appears to reflect the degree of dye binding in the plasma that governs the rate of BSP extraction by the liver. The accelerated dye disappearance associated with hypoalbuminemia may have clinical implications in patients with chronic parenchymal liver disease, in whom a low plasma albumin may tend to minimize the extent of BSP retention that would prevail if the albumin level were normal.