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Albumin

Proteins circulate throughout your blood to help your body maintain fluid balance. Albumin is a type of protein the liver makes. It’s one of the most abundant proteins in your blood.

Albumin Test

Also Known as: Albumin, ALB, Serum Albumin

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Test Panel: Total Bilirubin, Conjagated Bilirubin, Unconjugated Bilirubin, ALT, AST, ALP, Total Protein, Albumin, Globulin, A/G ratio, GGT,

Why Get Tested:

This test is needed:

  • in liver diseases.
  • kidneys diseases and nephrotic syndrome patient.
  • In patients with severe burn.
  • As a part of other tests.
  • In a patient suspected of malnutrition.

When to get Tested:

  • when you have symptoms of a liver disorder
  • when you have symptoms of a kidney disease
  • When you have unintended weight loss
  • When you have symptoms associated with malnutrition

Sample Required

  • It is done on the serum of the patient.
    • How to get good serum: Take 3 to 5 ml of blood in the disposable syringe or in vacutainer. Keep the syringe for 15 to 30 minutes at 37 °C and then centrifuge for 2 to 4 minutes to get clear serum.
  • The random sample can be taken.
  • Use a freshly prepared serum or store at 4 °C which may be stable more than 72 hours.

Precaution for Sample

  1. Fasting sample is preferred.
  2. Specimen with lipemia or hemolysis should be avoided.
  3. Avoid prolonged tourniquet.
  4. Take into account physical exercise and fever where there is increased filtration.

Normal Values:

  • Total protein = 6.4 to 8.3 g/dL.
  • Albumin = 3.5 to 5 g/dL.
  • Globulin = 2.3 to 3.4 g/dL
  1. Acute and chronic inflammations: 
    • The cause is hemodilution, loss into extravascular space, increased consumption by the cells and decreased synthesis.
      • like Rheumatoid arthritis, granulomatous process, most bacterial infections, vasculitis, ulcerative bowel disease, and certain parasitic infestation.
  2. Due to decreased synthesis by the liver:
    • This may be due to the increased amount of immunoglobulins, loss of albumin into the extravascular space.
    • This may be also due to the decreased synthesis because of toxins or alcohol.
    • The liver can compensate for the synthesis of albumin approximately up to 95% of the loss of liver function.  
      • In acute and chronic liver diseases, Amyloidosis, Malignancies, Congestive heart disease, and constrictive pericarditis.
  3. Urinary loss:
    • As albumin is relatively small and globular, a significant amount is filtered into the glomerular urine. Then the majority is reabsorbed by the proximal tubular cells.
    • Normal urine contains 20 mg of albumin per gram of creatinine.
      • Excretion above this level is seen in:
        • Increased glomerular filtration.
        • Tubular damage.
        • Hematuria.
        • Or a combination of the above factors.
    • Examples are:
      1. In  Nephrotic syndrome.
      2. Thermal burns.
      3. Trauma and crush injuries.
      4. Transudation and exudation from any hollow organs.
      5. Increased loss via body fluids.
  4. Increased catabolism:
    1. leads to decrease albumins like fever, antimetabolites, thyrotoxicosis, and certain malignancies.
  5. A gastrointestinal loss:
    1. With the inflammatory disease of GIT. 
    2. Chronic protein-losing enteropathy.
  6. Increased blood volume (hypervolemia):
    1. This leads to a decrease in albumins like exogenous estrogen therapy, Myeloma, and congestive heart failure.
    2. Serum level decreases in pregnant ladies.
    3. The person on a low protein diet.
  7. It decreases:
    1. After weight loss surgery.
    2. Whipple disease.
    3. Sprue.
    4. Crohn’s disease.
  8. Analbuminemia is a rare genetic deficiency where plasma albumin level is <0.5 g/L. Major clinical manifestations are related to abnormal lipid transport.
  9. Summary of decreased albumin:
    1. Inflammations.
    2. Hepatic diseases.
    3. Urinary loss.
    4. Gastrointestinal loss.
    5. Edema and ascites.
    6. Protein malnutrition

Albumin level increases in:

  1. Naturally, there is no reason for the increase in the albumin level.
  2. Dehydration or any other cause leading to a decrease in the plasma volume causes an increase in the level.
  3. High protein diet.
  4. When the tourniquet is applied for a long time. 

Tabulated causes of Hyperalbuminemia and Hypoalbuminemia:

HypoalbuminemiaHyperalbuminemia
Nephrotic syndromeDehydration
BurnsHigh protein diet
Blood lossFalse value due to prolonged tourniquet
Malignancies 
Inflammatory process 
Liver diseases 
Decreased protein intake 
Ascites

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