study, the most important risk factor for the development of candidemia was malnutrition. A reduced serum albumin level is an independent risk factor for nosocomial infections. The greater the protein malnutrition, the greater the risk for nosocomial infections.

In summary, serum albumin concentrations provide the clinician with a tool to help predict recovery or mortality. Albumin levels should be monitored at regular intervals (every 3 or 4 days) for hospitalized patients who are ill and at risk for malnutrition. Once hypoalbuminemia is documented, it is not an ideal indicator of nutritional rehabilitation since it returns to normal slowly (21-day half-life) and lags behind other indices of nutritional status, such as transferrin (7-day half-life), prealbumin (1-day half-life), or retinol binding protein (4-h half-life). Albumin replacement does not reverse the metabolic process that the hypoalbuminemia state represents. The reduced level of protein reserves in the patient and the severity of the metabolic injury or cancer are the two most important determinants of serum albumin level.

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