Patient Test Information

Albumin

Also known as:

ALB

Formal name:

Albumin, serum

Related tests:

Liver Panel, Comprehensive Metabolic Panel, Urine Albumin, Urinalysis, Total Protein, Creatinine, BUN, Renal Panel

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Why Get Tested?

To screen for and help diagnose a liver disorder or kidney disease; sometimes to evaluate nutritional status, especially in hospitalized patients

When to Get Tested?

Routinely as part of the blood tests done for a physical; when a healthcare practitioner thinks that you have symptoms of a liver disorder or kidney disease; sometimes when you have unintended weight loss, have symptoms associated with malnutrition, or prior to a planned surgery

Sample Required?

A blood sample drawn from a vein in your arm

Test Preparation Needed?

None

How is it used?

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.

When is it ordered?

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.

What does the test result mean?

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.

Is there anything else I should know?

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.

What is being tested?

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 plasma volume (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.

For more information, read The Test tab.

How is the sample collected for testing?

A blood sample is taken by a needle from a vein in the arm.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.

  1. Is anyone at high risk for abnormal albumin levels?

    Individuals who have chronic liver disease and kidney disorders are at highest risk for developing abnormal albumin levels. In addition, individuals whose gastrointestinal tract doesn't absorb nutrients properly and individuals who have prolonged diarrhea can develop abnormal albumin levels.

  2. Is there a home test for albumin levels?

    Not for blood albumin; you can test for high albumin levels in urine with a dipstick purchased in a drug store.

  3. 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.