Routinely as part of the blood tests done for a health exam or prior to a planned surgery; when a healthcare practitioner thinks that you have symptoms of a liver disorder or kidney disease; sometimes when you have unintended weight loss or have symptoms associated with malnutrition
A blood sample drawn from a vein
Albumin is a protein made by the liver. It makes up about 60% of the total protein in the blood and plays many roles. This test measures the level of albumin in the blood.
Albumin keeps fluid from leaking out of blood vessels, nourishes tissues, and transports hormones, vitamins, drugs, and substances like calcium throughout the body. Levels of albumin may decrease, to a greater or lesser degree, when conditions interfere with its production by the liver, increase protein breakdown, increase protein loss via the kidneys, and/or expand the volume of plasma, the liquid portion of blood (diluting the blood).
Two important causes of low blood albumin include:
- Severe liver disease—since albumin is produced by the liver, its level can decrease with loss of liver function; however, this typically occurs only when the liver has been severely affected.
- Kidney disease—one of the many functions of the kidneys is to conserve plasma proteins such as albumin so that they are not released along with waste products when urine is produced. Albumin is present in high concentrations in the blood, and when the kidneys are functioning properly, virtually no albumin is lost in the urine. However, if a person's kidneys become damaged or diseased, they begin to lose their ability to conserve albumin and other proteins. This is frequently seen in chronic diseases, such as diabetes and hypertension. In nephrotic syndrome, very high amounts of albumin are lost through the kidneys.
How is the test used?
An albumin test may be used, along with other tests included in panels such as a comprehensive metabolic panel (CMP), to help evaluate your overall health status. These tests may also be used to help diagnose diseases and to monitor conditions or treatments. Albumin levels can be low in many different diseases and disorders. Abnormal results may indicate the need further testing.
Additionally, an albumin test may be ordered as part of a liver panel to evaluate liver function or with a creatinine, blood urea nitrogen (BUN), or renal panel to evaluate kidney function. Albumin may also be ordered to evaluate a person's nutritional status.
When is it ordered?
An albumin test is frequently ordered as part of a panel of tests when you have a routine health exam.
- Yellowing of eyes or skin (jaundice)
- Weakness, fatigue
- Unexplained weight loss
- Loss of appetite
- Abdominal swelling and/or pain
- Dark urine, light-colored stool
- Itching (pruritus)
This test may be ordered when you have signs and symptoms of nephrotic syndrome, such as:
- Swelling or puffiness, particularly around the eyes or in the face, wrists, abdomen, thighs or ankles
- Urine that is foamy, bloody, or coffee-colored
- A decrease in the amount of urine
- Problems urinating, such as a burning feeling or abnormal discharge during urination, or a change in the frequency of urination, especially at night
- Mid-back pain (flank), below the ribs, near where the kidneys are located
- High blood pressure (hypertension)
A healthcare practitioner may also order an albumin test to check or monitor your nutritional status. However, since albumin levels respond to a variety of conditions in addition to malnutrition, a decrease in albumin needs to be evaluated carefully.
What does the test result mean?
A low albumin level may be an indication that further investigation may be warranted. A low albumin may reflect a temporary condition that will resolve itself or may suggest an acute or chronic condition that requires treatment.
Levels of albumin may decrease, to a greater or lesser degree, when conditions interfere with its production, increase protein breakdown, increase protein loss, and/or expand plasma volume (diluting the blood). Depending on your medical history, signs and symptoms, and physical exam, additional testing may be done to investigate a low result.
A low albumin can suggest liver disease. Liver enzyme tests or a liver panel may be ordered to determine exactly which type of liver disease may be present. A person may, however, have normal or near normal albumin levels with liver disease until the condition has reached an advanced stage. For example, in people with cirrhosis, albumin is typically (but not always) low whereas in most chronic liver diseases that have not progressed to cirrhosis, albumin is usually normal.
Low albumin levels can reflect kidney diseases in which the kidneys cannot prevent albumin from leaking from the blood into the urine and being lost. In this case, the amount of albumin or protein in the urine also may be measured (see Urine Albumin) or tests for creatinine and BUN or a renal panel may be ordered.
Low albumin levels can also be seen in inflammation, shock, and malnutrition. They may be seen with conditions in which the body does not properly absorb and digest protein, such as Crohn disease or celiac disease, or in which large volumes of protein are lost from the intestines.
A low albumin may also be seen in several other conditions, such as:
- Chronic illness
- Underactive thyroid (hypothyroidism)
- Carcinoid syndrome
- Increase in blood volume due to congestive heart failure, sometimes pregnancy
High albumin levels can be seen with dehydration, although the test is not typically used to monitor or detect this condition.
Is anyone at high risk for abnormal albumin levels?
Is there a home test for albumin levels?
What is the difference between serum/plasma albumin, prealbumin, and urine albumin tests?
Although the names are similar, albumin and prealbumin are completely different molecules. They are both proteins made by the liver, however, and both have been used historically to evaluate nutritional status. Serum/plasma (or blood) albumin is now more often used to screen for and help diagnose liver or kidney disease and is tested on a blood sample. The urine albumin test (in the past, called a microalbumin test) detects and measures albumin in the urine as an early indicator of kidney damage.
Is there anything else I should know?