Explanation of Kwashiorkor The reason we feel this patient if not suffering from kwashiorkor is the intact muscle and normal albumin levels. If the patient continues to receive the dextrose hydration without initiation of nutrition support, the patient could enter into a kwashiorkor or combination state. We feel this way because on admittance, the patient had normal total protein and albumin levels, once the patient was placed on hydration, the levels decreased minimally.