ALB and Ascites: The factors that contribute to zinc deficiency in persons with CLD are as follows: (a) a decrease in albumin-bound zinc due to impaired albumin synthesis in the liver, leading to an increased urinary excretion of amino acid-bound zinc;(1) (b) reduced zinc intake due to decreased appetite;(9) (c) impaired absorption of zinc from the intestine, possibly due to portal hypertension;(10,11) and (d) increased zinc excretion caused by diuretics used for the treatment of ascites and oedema.(12)