Abrupt loss of albumin is most commonly associated with which condition?

• A. Nephrotic syndrome
• B. Cirrhosis
• C. Burns
• D. Malignancy

Answer: (A)

Heavy urinary protein loss in nephrotic syndrome causes a rapid drop in circulating albumin. Albumin is the main plasma protein made by the liver, but when the glomerular filtration barrier is damaged, albumin leaks into the urine in large amounts. This protein loss outpaces liver synthesis, leading to marked hypoalbuminemia and a drop in plasma oncotic pressure, which pulls fluid into the interstitial space and produces edema quickly.

In cirrhosis the low albumin mostly reflects reduced synthesis and chronic changes rather than an abrupt loss. Burns can cause protein to escape from the vascular space due to increased capillary permeability, but the classic, brisk loss of albumin is best explained by nephrotic-range proteinuria. Malignancy can contribute to low albumin through poor intake or inflammation, but not via an abrupt, kidney-mediated loss.