Diagnostic Use
Increased albumin concentrations are either due to prolonged venostasis during specimen collection (artefactual), or dehydration.
Decreased concentrations may be due to
dilution (IV fluids, specimen taken from “drip arm”),
decreased synthesis ( liver failure)
increased loss (nephrotic syndrome, burns, protein-losing enteropathy)
shift to extravascular space (inflammation, trauma)
increased catabolism ( malignancies, thyrotoxicosis, inflammation).
analbuminemia (a rare genetic disorder)
Serum albumin is NOT a nutritional marker
Serum albumin decreases in response to a wide range of illnesses and trauma. Inflammation causes a cytokine-mediated shift to the extravascular space. Conversely, even severe malnutrition states such as marasmus and anorexia nervosa are not usually accompanied by decreased albumin levels. The only malnutrition state associated consistently with low albumin is Kwashiorkor. For these reasons, albumin is not useful as a nutritional marker, despite its traditional use in this role.
Serum-Ascites Albumin gradient (SAAG):
SAAG i.e. Plasma albumin minus by Ascitic fluid albumin (in g/L) has been used to distinguish 2 big groups of causes for ascites :
– portal hypertension related (e.g. liver cirrhosis or congestive heart failure) with SAAG described in literature as usually >=11g/L
– non-portal hypertension related (e.g malignant ascites, tuberculosis, pancreatitis) with SAAG described in literature as usually <11g/L
However, using cut point of 15g/L instead of 11g/L may improve sensitivity for non-portal hypertension related causes without losing specificity.
References
1. Lee JL et al. (2015): Serum albumin and prealbumin in carorically restricted, nondiseased individuals: a systematic review. Am J Med 128:1023.e1-1023.e22
2. Friedman, A. N. and S. Z. Fadem (2010). "Reassessment of albumin as a nutritional marker in kidney disease." J Am Soc Nephrol 21 (2): 223-230.
Reference Intervals
Units : g/L
| Age |
| 0 – 3 months |
25 – 40
|
| 3 – 12 months |
32 – 45 |
| > 1 year |
32 – 48 |
| Pregnancy |
| 2 – 14 weeks |
32 – 45
|
| 14 – 28 weeks |
27 – 37
|
| 28 – 42 weeks |
25 – 35 |
http://testguide.adhb.govt.nz/EGuide/?download=1773020346073Albumin%20method%20change%20document%20-%20August%20201.docx
Test Method
Principle : Dye-binding to bromocresol purple (BCP)
Analyser : Cobas
Uncertainty of Measurement
Uncertainty of Measurement: 6%