ALB and nephrotic syndrome: However, pre- as well as during HD it is crucial to consider factors that might influence cortisol concentration and thus interpretation of adrenal function test results: Since glucocorticoids are transported in the blood by corticosteroid-binding globulin (CBG) and albumin, these factors especially include conditions with increased or decreased CBG or albumin such as nephrotic syndrome, liver disease, critical illness, pregnancy or treatment with estrogen-containing oral contraceptives [25–28].