I. Introduction

Lower-than-normal levels of albumin can be caused by liver disease, infections, kidney disease, thyroid disease, inflammatory bowel disease, and malnutrition, while severe diarrhea or dehydration can cause a higher-than-normal albumin level. In 2018, 4.5 million American adults were diagnosed with liver disease, according to the Centers for Disease Control and Prevention. Approximately 14% of the American population has kidney disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases. No population-level statistics are available on dehydration, but it’s much more common in elderly people than it is in adolescents, young adults, and middle-aged adults.

This guide provides an overview of the albumin test, including what it entails and what the results mean. It also contains information on liver disease, kidney disease, and dehydration, all of which can cause an abnormal albumin level.

II. Overview of the Albumin Test

Why should I get tested?

The purpose of the albumin blood test is to determine if an individual has too much or too little albumin in the bloodstream. This test is used to diagnose liver disease, kidney disease, malnutrition, dehydration, infections, and other conditions that can affect albumin production or increase the amount of albumin excreted in the urine.

When should I get tested?

According to MedlinePlus, the albumin test should be ordered any time an individual has signs of liver or kidney disease. The albumin test may also be ordered as part of a comprehensive metabolic panel, a blood test that measures 14 substances. The CMP is often ordered as part of an annual physical, and it can provide essential information about an individual’s kidney and liver function.

What is required for the test?

To have the albumin test, an individual must provide a blood sample.

What do I need to do to prepare for the test?

No special preparation is required for the albumin test, but if it’s ordered as part of a comprehensive metabolic panel, it may be necessary to fast for 10 to 12 hours before having blood drawn. Fasting is recommended because the CMP measures the amount of glucose in the blood. Glucose levels are affected by food and some beverages; therefore, fasting before a CMP can produce a more accurate glucose result.

III. The Basics of Liver Disease, Kidney Disease, and Dehydration

Liver Disease

Liver disease is a general term used to describe any disease that affects liver function. Viral infections cause some liver diseases such as hepatitis A. Consuming too much alcohol or taking illicit drugs can lead to liver problems such as cirrhosis and fatty liver disease. Genetic disorders, which are caused by abnormal DNA, can also affect the liver. Wilson disease and hemochromatosis are examples of liver diseases that occur due to abnormalities in a person’s DNA. Liver cancer, a condition that develops when cells in the liver start dividing rapidly, is another example of liver disease.

Several risk factors increase an individual’s chance of developing liver disease. Because alcohol, illicit drugs, and taking too much of certain prescription and over-the-counter medications can damage the liver, the American Liver Foundation recommends avoiding unnecessary medications, never mixing medications or illicit drugs with alcohol, and never mixing medications unless advised to do so by a medical professional. Chemicals found in spray cans, such as pesticides and aerosol cleaners, can also damage the liver, so it’s critical to wear a mask, open the windows, or use these products outdoors. To reduce the risk of hepatitis, people should not share needles, razors, or other sharp objects with each other. Avoiding unprotected sex can also help reduce the risk of contracting hepatitis. Finally, the American Liver Foundation recommends losing excess weight, eating a well-balanced diet, avoiding tobacco products, and drinking alcohol responsibly to reduce the risk of liver disease.

Common symptoms of liver disease include abdominal swelling, yellowing of the skin (jaundice), easy bruising, leg swelling, and a change in the color of urine or bowel movements. However, liver disease doesn’t always cause symptoms, so an albumin test is important to determine if the liver is functioning normally.

Kidney Disease

Kidney disease develops when something damages the kidneys, preventing them from carrying out their normal functions. The kidneys are responsible for filtering the blood, which involves filtering wastes into the urine and stopping too much fluid from building up in the bloodstream. Healthy kidneys also help control blood pressure, the production of red blood cells, and vitamin D levels by producing the hormones needed to carry out these functions. In people with kidney disease, the damaged kidneys leak albumin into the urine, a condition known as microalbuminuria. Therefore, some people with kidney disease have too much albumin in their urine and too little albumin in their blood.

Risk factors for kidney disease include high blood pressure, diabetes, a family history of kidney disease or kidney failure, and heart disease. Some of these risk factors can be modified; for example, taking medication to control high blood pressure can reduce the risk of developing kidney disease. At first, kidney disease may not cause any symptoms, which is why it’s important to have blood tests to assess kidney function. Once it advances, kidney disease can cause symptoms such as dry skin, itching, headaches, fatigue, reduced appetite, muscle cramps, difficulty sleeping or concentrating, and weight loss.

Dehydration

Dehydration can occur any time a person loses an excessive amount of fluid. Potential causes of dehydration include severe diarrhea or vomiting, frequent urination, high fever, and excessive sweating. Dehydration also occurs when someone loses more fluid than they take in; therefore, not drinking enough fluids can also cause dehydration.

Several factors increase the risk of developing dehydration, including working or exercising in a hot environment, taking medications that cause sweating or increased urination, and having a chronic illness that causes sweating. Older people have an elevated risk of dehydration because the sense of thirst is reduced as a person ages. Infants and children also have an increased risk of dehydration because they are more likely to develop severe vomiting or diarrhea. Symptoms of dehydration include dry mouth, extreme thirst, dry skin, fatigue, darker-than-usual urine, and dizziness. People with dehydration may have higher-than-normal levels of albumin because the loss of fluid makes the blood plasma more concentrated.

IV. How an Albumin Test Works

The albumin test is performed on a blood sample, which is usually obtained by a phlebotomist working in a hospital, clinic, or other medical facility; however, home test kits are available to make it easier and more convenient to collect the required blood sample. To ensure an accurate result, it’s essential to follow the directions that come with the kit when collecting blood, labeling it, and returning it to the laboratory.

Laboratory personnel determine the amount of albumin in a blood sample by performing a colorimetric assay. This procedure involves using a colorimeter to measure how much light the albumin absorbs, which makes it possible to determine the concentration of albumin in the sample.

V. Treatment for Liver Disease, Kidney Disease, and Dehydration

Liver Disease

The right treatment plan depends on what type of liver disease an individual has, how advanced the disease is, and other factors. Antiviral medications may be used to treat hepatitis A and hepatitis C, both of which are caused by viruses. Cirrhosis is irreversible, but it’s possible to treat some of the underlying causes of the disease. For example, an individual with alcoholic fatty liver disease may be advised to abstain from alcohol. People with nonalcoholic fatty liver disease can benefit from losing excess weight and getting regular exercise. If an individual developed liver disease after taking medication, stopping the medication can prevent additional liver damage.

Liver cancer is treated with chemotherapy, radiation therapy, or surgery, all of which destroy cancer cells. An individual with liver cancer may work with an oncologist (cancer specialist) to determine which treatment method offers the best chance of recovery. If the liver stops working completely — a condition known as liver failure — the only available treatment option is a liver transplant. During this procedure, a surgeon removes the damaged liver and replaces it with a healthy liver from a living or deceased donor.

Kidney Disease

For people with kidney disease, controlling high blood pressure and diabetes can help prevent additional kidney damage. This may involve taking medications, losing weight, or making dietary changes. For example, someone with kidney disease and high blood pressure may have to follow the DASH diet, an eating plan that emphasizes low-fat dairy products, fruits, and vegetables. The DASH diet also limits the consumption of saturated fat and total fat. People with diabetes should check their glucose levels regularly and ask their health care providers for help if they have trouble meeting their targets. Some medications damage the kidneys, so an individual with kidney disease may be advised to take smaller doses of a medication or stop taking the medication entirely.

If kidney function continues to decline, an individual may go into kidney failure. Hemodialysis or peritoneal dialysis may be needed to filter excess fluid and wastes out of the blood. During a hemodialysis session, blood is removed from the body, cleaned by a machine, and then returned to the bloodstream. Peritoneal dialysis requires the placement of a catheter in the abdomen. The catheter is used to deliver dialysis solution to the peritoneal cavity, where it absorbs extra fluid and waste products. The used dialysis solution is removed from the body by a second tube. Some people with kidney failure will eventually need kidney transplants. During a kidney transplant, a surgeon places a donated kidney inside the individual’s body. This new kidney takes the place of the damaged kidneys, filtering the blood and preventing too much fluid from building up in the body.

Dehydration

Mild dehydration can be treated by drinking sports drinks, sucking on ice chips, and sipping water. If dehydration is due to severe diarrhea, treating the diarrhea with dietary changes and over-the-counter medications can help. Severe dehydration may require treatment with IV fluids, which requires a visit to a hospital or an urgent care facility. An IV delivers fluid directly into the bloodstream, relieving the symptoms of dehydration and reducing the risk of complications.

VI. FAQs

What is a normal albumin level?

A normal albumin level ranges from 3.4 to 5.4 grams per deciliter of blood (g/dL).

My albumin level was low, so my doctor wants to test me for microalbuminuria. What does this mean?

Microalbuminuria is a condition characterized by a urine albumin level ranging from 31 to 299 milligrams per deciliter of urine. The presence of this condition indicates that something is causing albumin to leak into the urine. In many cases, it’s a problem with the kidneys that causes microalbuminuria to occur. To have this test, an individual must provide a urine sample and have it analyzed by a clinical laboratory.

How long does it take to get the results of an albumin test?

It typically takes one day for a laboratory to test a blood sample and prepare a report documenting the results; however, it may take longer for an individual to receive their test results. The ordering physician may have to wait for the results of other tests before contacting the patient.

Does a low albumin level mean something is definitely wrong with my kidneys or liver?

No. Albumin levels can also be low due to infections, malnutrition, thyroid disease, and inflammatory bowel disease. A low albumin level is not an absolute indicator that an individual has kidney disease or liver disease.

Can any medications affect my albumin levels?

Yes. Insulin, steroids, and certain hormones can cause an increase in albumin. Birth control pills and some other medications can reduce the level of albumin.

VII. Additional Resources

To learn more about liver disease, kidney disease, dehydration, and testing for these conditions, use the following resources.

NameWebSummary
American Liver Foundationwww.liverfoundation.org/The American Liver Foundation offers a variety of resources on managing liver disease.
National Institute of Diabetes and Digestive and Kidney Diseaseswww.niddk.nih.gov/The NIDDK provides a wealth of information on kidney disease, including how to prevent it and what to do to reduce the risk of complications.
National Kidney Foundationwww.kidney.org/Learn more about microalbuminuria and other signs and symptoms of kidney disease.
Cleveland Clinicwww.my.clevelandclinic.org/The Cleveland Clinic offers tips for preventing dehydration.
American Kidney Fundwww.kidneyfund.org/Learn how to manage kidney disease by making good food choices.

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