Albumin (along with total protein) is a part of a diverse microenvironment. Its primary function is the maintenance of colloidal osmotic pressure in the vascular and extravascular spaces (e.g., urine, cerebrospinal fluid, amniotic fluid). Albumin is a source of nutrition and a part of a complex buffer system. It is a “negative” acute-phase reactant. It decreases in response to acute inflammatory infectious processes.

Albumin is used to evaluate nutritional status, albumin loss in acute illness, liver disease and kidney disease with proteinuria, hemorrhage, burns, exudates or leaks in the GI tract, and other chronic diseases. Hypoalbuminuria is an independent risk factor for older adults for mortality—admission serum albumin in geriatric patients is a predictor of outcome.

Using Bromcresol Green Dye:

• Children: 3.8–5.4 g/dL or 38–54 g/L

• Adults: 3.5–5.2 g/dL or 35–52 g/L

In persons older than 40 years and living in subtropics and tropics (secondary to parasitic infections), level slowly declines.

1. Obtain 5 mL of serum in a light green tube. Fasting is not necessary.

2. Centrifuge within 30 minutes of blood draw. Label the specimen with the patient’s name, date and time of collection, and test(s) ordered. Place specimen in a biohazard bag.

3. Observe standard procedures.

4. Urine specimens may also be collected (see Chapter 3).

1. Increased albumin is not associated with any naturally occurring condition. When albumin is increased, the only cause is decreased plasma water that increases the albumin proportionally: dehydration.

2. Decreased albumin is associated with the following conditions:

   1. Acute and chronic inflammation and infections

   2. Cirrhosis, liver disease, alcoholism

   3. Nephrotic syndrome, kidney disease (increased loss in urine)

   4. Crohn disease, colitis

   5. Congenital albuminemia

   6. Burns, severe skin disease

   7. Heart failure

   8. Starvation, malnutrition, malabsorption, anorexia (decreased synthesis)

   9. Thyroid diseases: Cushing disease, thyrotoxicosis

Pretest Patient Care

1. Explain test purpose and specimen collection procedure. No fasting is required.

2. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.