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Homodimeric N-terminal truncated albumin form proportion can independently stratify 1-year mortality in patients with ACLF.80 Many other different PTM in albumin were found increased in patients with liver cirrhosis, such as cysteinylated, glycated and truncated forms.11,77,87 As a consequence, native, non-modified albumin, is significantly reduced in patients with cirrhosis, particularly during clinical decompensation.11 The absolute reduction of native albumin or the reduction in the proportion of native to total albumin were able to predict mortality in patients with liver cirrhosis, outperforming total albumin concentration as a prognostic marker.11,82 Because modified albumin forms consistently present compromised function, it is clinically more relevant to estimate the concentration of fully functional native albumin concentration than total albumin concentration, and hence it has emerged the new concept of effective albumin concentration.11,28Table 2 summarizes the modified forms of albumin in liver disease