ALB and nutritional disorder: Third, serum albumin level could be influenced by different factors on its synthesis, break down, excretion as proteinuria, etc. Under various nutritional disorders, inflammatory conditions, and most critical glomerular diseases of proteinuria, and under such circumstances, using extensive adjustment of covariates in statistical analyses still cannot address the role of albumin level in relation to disease outcomes from pathogenesis point of view or from mechanisms of disease progress, especially the renal outcomes.