Medical Oncology

, Volume 17, Issue 2, pp 117–122 | Cite as

Urinary albumin excretion and transcapillary escape rate of albumin in malignancies

  • LM Pedersen
  • L Terslev
  • PG Sørensen
  • KH Stokholm
Original Paper


Transcapillary escape rate of albumin was determined in 22 patients with different malignancies. In addition, urinary albumin excretion rate was measured in 24-h urine samples using a sensitive immunoassay. Increased urinary albumin excretion was defined as ≥20 μg/min according to conventional standards. Renal glomerular filtration and tubular function was estimated by51Cr-EDTA plasma clearance and urinary beta 2-microglobulin, respectively. Median urinary albumin excretion rate was 15.0 μg/min (range 6–510 μg/min) and the frequency of increased urinary albumin excretion was 41%. This agrees with other studies showing increased albuminuria in several types of malignant diseases. Patients with advanced disease (tumour, node, metastasis (TNM) stage II–IV) had a significantly higher urinary albumin excretion rate than patients with localized disease (TNM stage I). Serum creatinine, glomerular filtration rate and urinary beta 2-microglobulin were all within normal limits. Median transcapillary escape rate of albumin was 5.5%/h (range 2–8%/h) and this level is comparable with values in healthy subjects. There was no significant difference in transcapillary escape rate between patients with elevated urinary albumin excretion and the normoalbuminuric group. Median value of the absolut outflux of albumin was 10.6 g/h with similar levels in patients with increased urinary albumin excretion and patients with normoalbuminuria. Our results indicate a high prevalence of minor glomerular dysfunction with a slightly elevated urinary albumin excretion in patients with malignancies. The normal endothelial function, as estimated by the transcapillary escape rate of albumin, suggests an overal unaffected capillary permeability and increased urinary albumin loss appears to be an isolated renal phenomenon in cancer patients.


albuminuria microalbuminuria transcapillary escape rate vascular permeability malignancy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Sawyer N, Wadsworth J, Wijnen M, Gabriel R. Prevalence, concentration, and prognostic importance of proteinuria in patients with malignancies.Br Med J 1988;296: 1295–1298.Google Scholar
  2. 2.
    Pedersen LM, Milman N. Prevalence and prognostic significance of proteinuria in patients with lung cancer.Acta Oncol 1996;35: 691–695.PubMedCrossRefGoogle Scholar
  3. 3.
    Roumen RMH, Wijnen MHA. Proteinuria: a frequent paraneoplastic phenomenon in colorectal cancer?Eur J Cancer 1998;34: 206–207.PubMedCrossRefGoogle Scholar
  4. 4.
    Puolijiko H, Mustonen J, Pettersson E, Pasternack A, Lahdensuo A. Proteinuria and haematuria are frequently present in patients with lung cancer.Nephrol Dial Transplant 1989;4: 947–950.Google Scholar
  5. 5.
    Pedersen LM, Milman N. Microalbuminuria in patients with lung cancer.Eur J Cancer 1998;34: 76–80.PubMedCrossRefGoogle Scholar
  6. 6.
    Hoyt RE, Hamilton JF. Ovarian cancer associated with the nephrotic syndrome.Obstet Gynecol 1987;70: 513–514.PubMedGoogle Scholar
  7. 7.
    Norris SH. Paraneoplastic glomerulopathies.Semin Nephrol 1993;13: 258–272.PubMedGoogle Scholar
  8. 8.
    Parving H-H, Gyntelberg F. Transcapillary escape rate of albumin and plasma volume in essential hypertension.Circ Res 1973;32: 643–651.PubMedGoogle Scholar
  9. 9.
    Jensen T, Bjerre-Knudsen J, Feldt-Rasmussen B, Deckert T. Features of endothelial dysfunction in early diabetic nephropathy.Lancet 1989;I: 461–463.CrossRefGoogle Scholar
  10. 10.
    Parving HH, Jensen HA, Westrup M. Increased transcapillary escape rate of albumin and IgG in essential hypertension.Scand J Clin Lab Invest 1977;37: 223–227.PubMedCrossRefGoogle Scholar
  11. 11.
    Hesse B, Parving HH, Lund-Jacobsen H, Noer I. Transcapillary escape rate of albumin and right atrial pressure in chronic congestive heart failure before and after treatment.Circ Res 1976;39: 358–362.PubMedGoogle Scholar
  12. 12.
    Ballmer PE, Ochsenbein AF, Schütz-Hoffmann S. Transcapillary escape rate of albumin positively correlates with plasma albumin concentration in acute but not in chronic inflammatory disease.Metabolism 1994;43: 697–705.PubMedCrossRefGoogle Scholar
  13. 13.
    Fleck A et al. Increased vascular permeability: a major cause of hypoalbuminaemia in disease and injury.Lancet 1985;I: 781–784.CrossRefGoogle Scholar
  14. 14.
    Marshall SM. Screening for microalbuminuria: which measurement?Diabetic Med 1991;8: 706–711.PubMedCrossRefGoogle Scholar
  15. 15.
    Brøchner-Mortensen J, Rødbro P. Optimum time of blood sampling for determination of glomerular filtration rate by single-injection51Cr-EDTA plasma clearance.Scand J Clin Lab Invest 1976;36: 795–800.PubMedCrossRefGoogle Scholar
  16. 16.
    Mogensen CE et al. Microalbuminuria: An early marker of renal involvement in diabetes.Uremia Invest 1986;9: 85–95.Google Scholar
  17. 17.
    Watts GFet al. Urinary albumin excretion in healthy adult subjects: reference values and some factors affecting their interpretation.Clin Chim Acta 1988;172: 191–198.PubMedCrossRefGoogle Scholar
  18. 18.
    Jensen JSet al. Urinary albumin excretion in a population based sample of 1011 middle aged non-diabetic subjects.Scand J Clin Lab Invest 1993;53: 867–872.PubMedCrossRefGoogle Scholar
  19. 19.
    Alpers CE, Cotran RS. Neoplasia and glomerular injury.Kidney Int 1986;30: 465–473.PubMedCrossRefGoogle Scholar
  20. 20.
    Fer MFet al. Cancer and the kidney: renal complications of neoplasms.Am J Med 1981;71: 704–718.PubMedCrossRefGoogle Scholar
  21. 21.
    Beutler B, Cerami A. Cachectin and tumours necrosis factor as two sides of the same biological coin.Nature 1986;320: 584–588.PubMedCrossRefGoogle Scholar
  22. 22.
    Lassen NA, Parving H-H, Rossing N. Filtration as the main mechanism of overall transcapillary protein escape from the plasma.Microvasc Res 1974;7: i-iv.PubMedCrossRefGoogle Scholar
  23. 23.
    Bent-Hansen L. Ininitial plasma disappearance and distribution volume of [1311]albumin and [1251]fibrinogen in man.Acta Physiol Scand 1989;136: 455–461.PubMedGoogle Scholar
  24. 24.
    Jensen JS et al. Microalbuminuria reflects a generalized transvascular albumin leakiness in clinically healthy subjects.Clin Science 1995;88: 629–633.Google Scholar
  25. 25.
    DeVries EGE, Beekhuis H, DeJong R, Mulder NH, Piers DA. Evidence for capillary leakage during chemotherapy in man.Eur J Clin Invest 1986;16: 243–247.CrossRefGoogle Scholar
  26. 26.
    Sørensen PG, Groth, S, Rossing N. The leakage of plasma albumin across small vessel walls during bleomycin treatment.Eur J Cancer Clin Oncol 1983;19: 29–32.PubMedCrossRefGoogle Scholar
  27. 27.
    Ballmer-Weber BK, Dummer R, Küng E, Burg G, Ballmer PE. Interleukin 2-induced increase of vascular permeability without decrease of the intravascular albumin pool.Br J Cancer 1995;71: 78–82.PubMedGoogle Scholar

Copyright information

© Macmillan Publishers Ltd All rights reserved 2000

Authors and Affiliations

  • LM Pedersen
    • 1
  • L Terslev
    • 1
  • PG Sørensen
    • 1
  • KH Stokholm
    • 2
  1. 1.Department of Oncology and HematologyRoskilde County HospitalDK-RoskildeDenmark
  2. 2.Department of Clinical Physiology and Nuclear MedicineKøge County HospitalDK-KøgeDenmark

Personalised recommendations