This test measures the amount of albumin in your blood and it is often performed as part of Liver Function Tests. Albumin is made in the liver and helps carry hormones, vitamins, drugs and minerals such as calcium through the bloodstream. One of its most important roles is helping to maintain fluid balance in the body by preventing fluid leaking from the blood vessels into other tissues. Without enough albumin fluid can build up in your lungs and other parts of your body.
Measuring albumin is a non-invasive way to check for the presence and severity of liver disease, which causes albumin levels to be low. Several tests can be ordered when one of these underlying conditions is suspected. The tests most commonly requested are Liver Function Tests, serum albumin, aminotransferases, bilirubin, alkaline phosphatase and prothrombin time. They are all performed on the same sample.

Albumin can also be low due to a range of health problems including kidney diseases and conditions where the intestine doesn't absorb nutrients. These include coeliac disease, Crohn's disease, and Ulcerative Colitis (UC) and malnutrition. High levels of albumin are a sign of dehydration. 

What is being tested?

Albumin is the most abundant protein in the blood plasma. It keeps fluid from leaking out of blood vessels; and carries hormones, vitamins, drugs, and minerals like calcium throughout the body. Albumin is made in the liver and is sensitive to liver damage.

The level of albumin in the blood is decreased when there is liver damage, in some types of kidney disease, in some patients who are severely malnourished, and in states of inflammation within the body, The albumin may be increased in dehydration.

How is it used?

Since plasma albumin is low in many different diseases and disorders, albumin testing is 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 serve as an indicator for other kinds of testing.

When is it requested?

The doctor requests a blood albumin test (usually along with several other tests) if a person seems to have symptoms of liver disorder  Albumin is often included in the liver function tests panel of blood tests.
An albumin test may also be requested to test for a kidney disease called nephrotic syndrome.  Your doctor may suspect this condition if you have swelling of the legs or abdomen, or if you have frothy or blood-stained urine.
Doctors may also request blood albumin tests when they want to check a person’s nutritional status, for example, when someone has lost a lot of weight or in someone with a gastrointestinal condition such as inflammatory bowel disease. In this situation prealbumin levels tend to fall earlier than albumin levels.

What does the result mean?

Low albumin levels can suggest liver disease. Liver function tests are requested to help determine which type of liver disease may be present.
Low albumin levels can reflect diseases in which the kidneys cannot prevent albumin from leaking from the blood into the urine and being lost (nephrotic syndrome). In this case, the amount of albumin (or protein) in the urine also may be measured.

Low albumin levels may also suggest conditions in which your body does not properly absorb and digest protein such as Crohn’s disease or in which large volumes of protein are lost from the intestine. Similarly low albumin may be seen in some patients with severe malnutrition.
Other causes for a low albumin level include inflammation and burns. 

Albumin is low during pregnancy.  This is a normal finding and does not indicate the presence of any disease.
High albumin levels usually reflect dehydration although the test is not used for this purpose. Dehydration is usually assessed by physical examination.

Common questions

  • Is anyone at high risk of abnormal albumin levels?

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

  • What is the difference between albumin, prealbumin and microalbumin test?

The prealbumin test measures a protein that reflects your nutritional status, particularly before and after surgery, or if you are hospitalised or taking nutritional supplements.

Albumin testing is more often used to test for liver or kidney disease or to learn if your body is not absorbing enough amino acids which are used to produce proteins such as albumin. Albumin can also be used to monitor nutritional status. However, prealbumin changes more quickly, making it more useful for detecting changes in short-term nutritional status than albumin.

The microalbumin or more accurately the albumin creatinine ratio urine (ACRU) test measures very small levels of albumin in your urine and may indicate whether you are at risk for developing kidney disease. However, the term microalbumin is not used today and has been replaced by urine albumin. If you are diabetic, you should have an albumin: creatinine ratio test measured at least yearly, to check for the development of diabetes-associated kidney disease.

  • Is there a home test for albumin?

No, not for blood albumin. You can test for urine albumin using a dipstick purchased from a pharmacy.

Last Updated: Thursday, 1st June 2023

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