ALB and endothelial dysfunction: Experimental data from HD patients suggest that a low albumin index due to oxidative modifications triggers an inflammatory response in endothelial cells, increasing mRNA expression of inflammatory cytokines (interleukins IL-6, IL-8 and IL-1β), and oxidized HD albumin upregulates the vascular cell adhesion molecule (VCAM) in endothelial cells [34], causing inflammation and endothelial dysfunction.