Relationship between serum albumin and parenteral nutrition-associated cholestasis

In a prospective study of 59 patients receiving total parenteral nutrition we found that patients with low serum albumin were more likely to develop cholestasis than patients with normal serum albumin. Only 25% of patients with a normal serum albumin developed cholestasis. Seventy-nine percent of patients with low serum albumin (<3.5 g/dl) developed cholestasis (p<0.01). In those patients who developed cholestasis, there was a significant correlation (r = 0.63, p < 0.01) between the serum albumin and the number of days after onset of total parenteral nutrition when cholestasis appeared. The role of hypoalbuminemia in the development of total parenteral nutrition-associated cholestasis deserves further study.