Multiple markers of hepatic function (aspartate aminotransferase, alkaline phosphatase, total bilirubin, and albumin), renal function (estimated glomerular filtration rate), together with echocardiographic parameters of the left heart (left ventricular ejection fraction and LV mass), pulmonary artery systolic pressure, and TR became progressively abnormal from normal to severe hepatorenal dysfunction and malnutrition. The gene discussed is ALB; the disease is malnutrition.