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What is Albumin Test?
Albumin is a protein secreted by liver cells that enters the blood circulation after synthesis. It is the most abundant protein present in plasma. Its normal range is about 3.5 – 5 g/dl constituting more than half of the plasma protein.
Albumin controls the oncotic pressure in blood and helps to transport various substances like bilirubin, ions, fatty acids and certain drugs. These substances are called ligands.
Clinically, the Serum Albumin Test measures the functional capacity of the liver. It is a very basic medical laboratory procedure and bovine serum is used as the laboratory standard.
The Albumin Test is often combined with prothrombin time and the International Normalised Ratio (INR) test to assess the full biosynthetic capability of the liver.
Frequently Asked Questions:
How is the albumin test performed?
An albumin test is performed following your doctor's advice. A sample of blood is collected from the patient in a medical laboratory, and the albumin levels are measured.
In what conditions is serum albumin level decreased (hypoalbuminemia)?
Serum albumin level is decreased in situations like liver failure associated with collection of fluid in body spaces (Ascites). Other conditions include renal failure and congestive heart disease. It is also associated with impaired absorption of food or malabsorption and generalised collection of fluid in body spaces (anasarca).
In what conditions is serum albumin level temporarily decreased or reversible hypoalbuminemia seen?
Reversible hypoalbuminemia is seen associated with fasting and malnourishment. It is also associated with inflammatory diseases. Therefore, Serum Albumin Test should be included in the diagnostic workup to check the progression of such conditions.
Why is the Serum Albumin Test so important in the detection of Ascites?
Ascites is a condition that involves the accumulation of fluid in the peritoneal spaces. It can be due to a number of reasons including liver cirrhosis, alcoholic liver diseases, malignancy, renal failure or congestive heart failure.
Medically, the clinician will drain the fluid due to ascites by a process known as paracentesis. They will then assess the values of Serum Albumin and Albumin in the ascitic fluid to determine the Serum Ascites Albumin Gradient (SAAG).
A median value of 1.1 is considered the SAAG gradient. Values above 1.1 suggest diseases that cause the increased blood pressure of liver blood vessels or portal hypertension. These conditions include liver cirrhosis, congestive heart failure and alcoholic liver disease.
A SAAG value of less than 1.1 is seen in carcinomatosis, tuberculosis, sclerosis and nephrotic syndrome.
Are there any contraindications for the albumin test?
No, the Albumin Test is a very basic laboratory test without any serious contraindications or side effects.
What is the normal range of serum albumin levels?
The normal serum albumin level is 3.5 - 5 g/dl or 35 - 50 g/l.
What are the preparations required before a serum albumin test?
Follow your healthcare provider's instructions. Avoid certain medications like insulin, growth hormone and steroids, which can increase your serum albumin level. Consuming large amounts of water or intravenous fluids and a low protein diet can alter your serum albumin level.
What are the symptoms suspected before an albumin test is recommended?
Jaundice or yellowish discolouration of skin and eye, itching, swelling, oedema in the ankles, dark-colored urine, abdominal pain, and pale-coloured stool are some symptoms suspected before proceeding to an albumin test.
Can you detect albumin in urine?
Yes, albumin can be detected from your urine in people with kidney disease. The test is called a microalbumin test.
Is there any condition that causes hyperalbuminemia?
Yes, increased serum albumin and transaminase are associated with a high-protein diet. However, this correlation should be studied further.
How is serum albumin test associated with orthopaedic surgeries?
A low serum albumin level is associated with surgical site infection in orthopaedic surgery patients.
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References:
- Moman RN, Gupta N, Varacallo M. Physiology, Albumin. [Updated 2022 Jan 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan
- Varacallo MA, Herzog L, Toossi N, Johanson NA. Ten-Year Trends and Independent Risk Factors for Unplanned Readmission Following Elective Total Joint Arthroplasty at a Large Urban Academic Hospital. J Arthroplasty. 2017 Jun;32(6):1739-1746.
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