title: In patients with cirrhosis, serum albumin determination should be carried out by immunonephelometry rather than by protein electrophoresis.
abstract: OBJECTIVE
  Serum albumin is a key parameter for prognosis in cirrhosis. We compared levels of serum albumin determined by both protein electrophoresis and immunonephelometry, with special reference to the Child-Pugh classification.
  
  
  METHODS
  One hundred and thirty-one patients, including 39 with cirrhosis, were included prospectively during 2 months. The aetiology of cirrhosis was mainly alcoholism (67%) and hepatitis C virus (HCV) (18%). Serum albumin was determined simultaneously by electrophoresis (Hydrasys SEBIA following protein determination by the biuret reaction) and by immunonephelometry (BECKMAN Nephelometer). Values were compared by non-parametric tests.
  
  
  RESULTS
  For the whole population, electrophoretic and immunonephelometric values correlated (p = 0.85; P < 0.0001), but electrophoresis significantly overestimated serum albumin by a median 1.6 g/l (P < 0.0001) with a large spread in values (range, -3.9 to 12.7). Median overestimation in cirrhosis was 2.6 g/l (P < 0.0001; range, -2.0 to 10.2) and 1.0 g/l (P < 0.0001; range, -3.9 to 12.7) in patients without cirrhosis (difference, P < 0.02). For 6/39 (15.4%) patients with cirrhosis, this overestimation led to an underestimation in the Child-Pugh classification.
  
  
  CONCLUSIONS
  In our experience, electrophoresis can lead to serum albumin values which are significantly different compared to those obtained by immunonephelometry. This discrepancy may lead to an incorrect Child-Pugh classification. Therefore, in the follow-up of cirrhotic patients, serum albumin should be determined by immunonephelometry.
authors.affiliation: Clinique des Maladies du Foie and INSERM U-522, Rennes, France. foulon@sunaimed.univ-rennes1.fr
authors.forename: M H
authors.initials: MH
authors.lastname: Mendler
authors.forename: S
authors.initials: S
authors.lastname: Corbinais
authors.forename: T
authors.initials: T
authors.lastname: Sapey
authors.forename: C
authors.initials: C
authors.lastname: Lucas-Clerc
authors.forename: V
authors.initials: V
authors.lastname: Tiisma
authors.forename: D
authors.initials: D
authors.lastname: Guyader
authors.forename: Y
authors.initials: Y
authors.lastname: Deugnier
authors.forename: A
authors.initials: A
authors.lastname: Le Treut
authors.forename: P
authors.initials: P
authors.lastname: Brissot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004586:Electrophoresis / Q000379:methods; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000145:classification; D008297:Male; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D012709:Serum Albumin