Low Albumin (Hypoalbuminemia) Blood Test

What is Hypoalbuminemia?

Hypoalbuminemia is a condition characterized by abnormally low levels of albumin, the most abundant protein in blood plasma. It is caused by liver disease reducing albumin production, kidney disorders like nephrotic syndrome causing albumin loss through urine, severe malnutrition, or chronic inflammatory conditions. The Kidney Function Profile is the most important test for diagnosis because it evaluates kidney function and identifies nephrotic syndrome as a primary cause of albumin loss.

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What causes hypoalbuminemia?

Hypoalbuminemia is caused by liver disease that reduces albumin production, kidney disorders like nephrotic syndrome that cause excessive albumin loss through urine, severe malnutrition with insufficient protein intake, or chronic inflammatory conditions that increase albumin breakdown. The liver is responsible for synthesizing albumin, so cirrhosis or hepatitis can dramatically reduce albumin levels. Kidney diseases, particularly nephrotic syndrome, allow large amounts of albumin to leak into urine, depleting blood levels. Malnutrition, protein-losing enteropathy, severe burns, and chronic infections can also lead to low albumin levels.

What is the best test for hypoalbuminemia?

The Kidney Function Profile is the most important test for hypoalbuminemia because it evaluates kidney function and identifies whether nephrotic syndrome or other kidney disorders are causing albumin loss through urine. This comprehensive panel measures creatinine, blood urea nitrogen (BUN), glomerular filtration rate (GFR), and other kidney markers that reveal protein-wasting kidney disease. The test directly measures serum albumin levels while assessing kidney health, which is critical since kidney-related albumin loss is one of the most common causes of hypoalbuminemia. Additional liver function tests may be recommended to evaluate albumin production if liver disease is suspected.

When should I get tested for hypoalbuminemia?

You should get tested if you experience persistent swelling in your legs, ankles, or abdomen (edema), unexplained fatigue and weakness, or if you have been diagnosed with liver disease, kidney disease, or malnutrition. Testing is also important if you notice foamy urine, which indicates protein loss through kidneys, or if you have chronic inflammatory conditions or are recovering from severe illness or surgery. People with symptoms of nephrotic syndrome, such as significant edema and weight gain from fluid retention, should get tested promptly to identify the underlying cause and prevent complications.

What are the symptoms of hypoalbuminemia?
The most noticeable symptoms of hypoalbuminemia include swelling (edema) in the legs, ankles, feet, and abdomen due to fluid accumulation, since albumin helps maintain fluid balance in blood vessels. You might also experience fatigue, weakness, muscle wasting, and difficulty healing from wounds or infections. Severe cases can cause ascites (abdominal fluid buildup), difficulty breathing from fluid in the lungs, and changes in mental function. Some people notice foamy or frothy urine, which indicates protein loss through the kidneys, along with unexplained weight gain from fluid retention despite loss of muscle mass.
Who is at risk for hypoalbuminemia?
People with chronic liver disease like cirrhosis or hepatitis are at high risk because the liver produces albumin. Those with kidney disorders, especially nephrotic syndrome, are vulnerable due to excessive protein loss through urine. Individuals with severe malnutrition, eating disorders, or digestive diseases that impair protein absorption face increased risk. Hospitalized patients, especially those critically ill or recovering from major surgery or burns, commonly develop hypoalbuminemia. People with chronic inflammatory conditions, heart failure, or cancer also have elevated risk due to increased protein breakdown and altered metabolism.
What happens if hypoalbuminemia is left untreated?
Untreated hypoalbuminemia can lead to severe and progressive edema throughout the body, including life-threatening pulmonary edema (fluid in the lungs) that impairs breathing. The condition increases susceptibility to infections because albumin plays a role in immune function and transporting antibodies. You may develop malnutrition complications as albumin is essential for transporting nutrients, hormones, and medications throughout the body. Severe cases can result in ascites requiring repeated drainage procedures, blood clots due to altered protein balance, and impaired wound healing. The underlying conditions causing hypoalbuminemia, such as liver or kidney failure, can progress to life-threatening complications without proper treatment.
Can hypoalbuminemia be diagnosed with a blood test?
Yes, hypoalbuminemia is definitively diagnosed with a blood test that measures serum albumin levels. Normal albumin levels range from 3.5 to 5.5 grams per deciliter, and levels below 3.5 g/dL indicate hypoalbuminemia. The Kidney Function Profile not only measures albumin but also evaluates kidney function through creatinine, BUN, and GFR to determine if kidney disease is causing albumin loss. Additional blood tests including liver function tests, complete metabolic panel, and urinalysis help identify whether low albumin results from decreased production, increased loss, or other metabolic factors, guiding appropriate treatment decisions.
How is hypoalbuminemia treated?
Treatment for hypoalbuminemia focuses on addressing the underlying cause while managing symptoms. If kidney disease is the cause, treatment may include medications like ACE inhibitors or corticosteroids to reduce protein loss, along with dietary protein adjustment. Liver disease requires managing cirrhosis or hepatitis with specific medications and lifestyle changes. Nutritional support with high-protein diets or supplements helps replenish albumin in cases of malnutrition, though this must be carefully balanced with kidney function. Diuretics help manage edema and fluid retention. In severe cases, intravenous albumin infusions provide temporary relief while underlying conditions are treated. Regular monitoring through blood tests ensures treatment effectiveness.
How can I prevent hypoalbuminemia?
Preventing hypoalbuminemia involves maintaining good liver and kidney health through limiting alcohol consumption, avoiding hepatotoxic medications, and managing conditions like diabetes and high blood pressure that can damage kidneys. Ensure adequate protein intake through a balanced diet including lean meats, fish, eggs, dairy, legumes, and nuts unless you have kidney disease requiring protein restriction. Regular health screenings help detect liver and kidney problems early before albumin levels drop. Promptly treating infections, managing chronic inflammatory conditions, and addressing digestive disorders that impair nutrient absorption also help prevent hypoalbuminemia. Stay well-hydrated and maintain a healthy weight to reduce stress on liver and kidneys.
What can I do at home for hypoalbuminemia?
At home, focus on consuming adequate high-quality protein from sources like chicken, fish, eggs, Greek yogurt, and legumes to support albumin production, adjusting intake based on your healthcare provider's recommendations if you have kidney disease. Elevate swollen legs and ankles when resting to reduce edema, and wear compression stockings if recommended. Limit sodium intake to prevent fluid retention and reduce swelling. Stay physically active with gentle exercise like walking to improve circulation and prevent muscle wasting. Monitor your weight daily, as sudden increases may indicate fluid retention requiring medical attention. Avoid alcohol completely if liver disease is contributing to your condition, and ensure adequate rest to support healing and recovery.
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