Albumin

An albumin test is routinely included in the panels of tests performed as part of a health examination, such as a comprehensive metabolic panel (CMP), so it is frequently used to help evaluate a person's overall health status.

Additionally, since albumin can be low in many different diseases and disorders, it may be used in a variety of settings to help diagnose disease, to monitor changes in health status with treatment or with disease progression, and as a screen that may indicate the need for other kinds of testing.

Albumin is a protein made by the liver that keeps fluid from leaking out of blood vessels, nourishes tissues, and transports hormones, vitamins, drugs, and substances like calcium throughout the body.

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.

An albumin test is frequently ordered as part of a panel of tests performed for a health screening.

Albumin may be ordered, along with other tests, when a person has symptoms of a liver disorder, such as:

• 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 a person has 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 a person's nutritional status. However, since albumin concentrations respond to a variety of conditions in addition to malnutrition, a decrease in albumin needs to be evaluated carefully.

Results of albumin testing are evaluated along with those from other tests done at the same time, such as the tests included in a comprehensive metabolic panel (CMP), or in follow up.

A low albumin level may be a warning and 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 medical intervention.

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 the person's 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 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 Crohns 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:

• Infection
• Burns
• Surgery
• Chronic illness
• Cancer
• Diabetes
• Hypothyroidism
• Carcinoid syndrome
• Plasma volume expansion 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.

Certain drugs increase albumin in the blood, including anabolic steroids, androgens, growth hormones, and insulin.

If someone is receiving large amounts of intravenous fluids, the results of this test may be inaccurate.