Albumin

CPT: 82040
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Test Details

Use

Evaluation of nutritional status, blood oncotic pressure; evaluation of renal disease with proteinuria and other chronic diseases.

High albumin may indicate dehydration. Look for increase in hemoglobin, hematocrit in such patients.

Low albumin is found with use of I.V. fluids, rapid hydration, overhydration; cirrhosis, other liver disease, including chronic alcoholism; in pregnancy and with oral contraceptive use; many chronic diseases including the nephrotic syndromes, neoplasia, protein-losing enteropathies (including Crohn's disease and ulcerative colitis), peptic ulcer, thyroid disease, burns, severe skin disease, prolonged immobilization, heart failure, chronic inflammatory diseases such as the collagen diseases and other chronic catabolic states.

Starvation, malabsorption, or malnutrition: In the absence of I.V. fluid therapy and in patients without liver or renal disease, low albumin may be regarded as an indication of inadequate body protein reserves. It is described as the most common nutrition-related abnormality in patients with infection.1 Serum albumin has a half-life of about 18 to 20 days. Its half-life is decreased in patients with catabolic states: infection and with protein loss through the kidneys (eg, nephrosis), gastrointestinal tract, and skin (eg, burns). Its prognostic application is most useful in patients with weight loss, anorexia, stress, surgical therapy, hemorrhage, and infection. Total iron binding capacity <240 μg/dL1 and/or low transferrin levels would support an impression of inadequate protein reserves. Absolute lymphocyte counts <1500/mm3 may also be seen with protein malnutrition.2 In severe malnutrition, albumin has been reported as <2.5 g/dL, total lymphocytes as <800/mm3 and TIBC as <150 μg/dL.2

Albumin levels ≤2.0−2.5 g/dL may be the cause of edema (eg, nephrotic syndrome, protein-losing enteropathies).

Albumin, prealbumin, and transferrin are regarded as “negative” acute phase reactants (ie, these proteins decrease with acute inflammatory/infectious processes).

Low albumin values are associated with longer hospital stay.1

Methodology

Colorimetric

Additional Information

Twenty-four hour urine collection to measure protein loss is helpful in work-up of some patients with hypoalbuminemia. Other tests useful in assessment of nutritional status include TIBC, transferrin, iron, absolute lymphocyte count, and vitamin B12/folate levels.

Specimen Requirements

Specimen

Serum (preferred) or plasma

Volume

1 mL

Minimum Volume

0.5 mL

Container

Red-top tube, gel-barrier tube, green-top (heparin) tube, or lavender-top (EDTA) tube

Collection

Separate serum or plasma from cells within 45 minutes of collection.

Storage Instructions

Maintain specimen at room temperature.

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Fluoride plasma specimen; gross hemolysis; lipemia; improper labeling

Clinical Information

Footnotes

1. Anderson CF, Wochos DN. The utility of serum albumin values in the nutritional assessment of hospitalized patients. Mayo Clin Proc. 1982 Mar; 57(3):181-184. 6801397
2. Shapiro M, Rhodes JB, Beyer PL. Malnutrition. Recognition and correction by enteral nutrition. J Kans Med Soc. 1983 Jun; 84(6):341-345, 356. 6409975

References

Tonks DB. A study of the accuracy and precision of clinical chemistry determinations in 170 Canadian laboratories. Clin Chem. 1963 Apr; 9:217-233. 13985504

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
001081 Albumin, Serum 1751-7 001081 Albumin, Serum g/dL 1751-7

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