Impaired albumin function may be caused by oxidative albumin damage, which has been found in several disease conditions including chronic liver failure. Three fractions of albumin can be discerned according to the redox state of cysteine-34: non-oxidized human mercaptalbumin (HMA) with Cys-34 as free sulfhydryl, reversibly oxidized human nonmercaptalbumin-1 (HNA1) with Cys-34 as mixed disulfide, and irreversibly oxidized human nonmercaptalbumin-2 (HNA2) with Cys-34 oxidized to sulfenic, sulfinic or sulfonic acid. The investigators of this study have previously reported marked oxidative albumin damage in decompensated cirrhosis and even more so in acute-on-chronic liver failure and these alterations were found to be related to prognosis.