NEWS & VIEWS that 3.0 g/dl. The patients who received albumin had slightly higher MAP than those who received saline; however, there were no significant differences in the
NATURE REVIEWS ¡NEPHROLOGY
total volume administered to patients, incidence of AKI, need for renal replacement therapy or mortality. The importance of large, well-designed trials and the pitfalls that plague small underpowered trials is again highlighted. Why did albumin resuscitation fail to improve outcomes compared with saline resuscitation in the ALBIOS study? In healthy individuals, albumin is thought to be the major contributor to the normal capillary oncotic pressure of 25-30 mmHg and although the concentration of albumin is highest in the intravascular space, 60% of capillary albumin is in the extravascular space. The transcapillary escape rate of albumin—that is, the fraction of intravascular albumin mass that passes to the extravascular space per unit time—is 5.6% ±1.1% per hour; after an infusion,
NATURE REVIEWS ¡NEPHROLOGY
total volume administered to patients, incidence of AKI, need for renal replacement therapy or mortality. The importance of large, well-designed trials and the pitfalls that plague small underpowered trials is again highlighted. Why did albumin resuscitation fail to improve outcomes compared with saline resuscitation in the ALBIOS study? In healthy individuals, albumin is thought to be the major contributor to the normal capillary oncotic pressure of 25-30 mmHg and although the concentration of albumin is highest in the intravascular space, 60% of capillary albumin is in the extravascular space. The transcapillary escape rate of albumin—that is, the fraction of intravascular albumin mass that passes to the extravascular space per unit time—is 5.6% ±1.1% per hour; after an infusion,
