Serum Albumin

Overview
  • Along with total protein, its primary function is the maintenance of the colloidal osmotic pressure in the vascular and extravascular spaces.
  • It is a source of nutrition and a part of the buffer system.
  • It is a “negative” acute-phase reactant.
  • It decreases in response to acute inflammatory infectious processes.
  • It is used to evaluate nutritional status, albumin loss in acute illness, liver disease and renal disease with proteinuria, hemorrhage, burns, exudates or leaks in the GI tract.
Normal Values:

Children: 2.9 – 5.5 g/dL or 22 – 55 g/L

Adults: 3.5 – 4.8 g/dL or 35 – 38 g/L

Procedure:
  • This is done by obtaining 5 mL of serum in a tube.
  • Fasting is not necessary.
  • Low levels are associated with edema. Assess patient for signs and symptoms.
Clinical Implications:
  • Increased albumin:
    1. Not associated with any naturally occurring condition.
    2. The only cause is decreased plasma water such as in dehydration.
  • Decreased albumin:
    1. acute and chronic inflammations and infections
    2. cirrhosis, liver disease, alcoholism
    3. nephrotic syndrome, renal disease
    4. Chron’s disease, colitis
    5. congenital analbuminemia
    6. burns, severe skin disease
    7. heart failure
    8. starvation, malnutrition, malabsorption, anorexia
    9. Cushing’s disease, thyrotoxicosis
Interfering Factors:
  1. Pregnancy (last trimester, owing to increased plasma volume)
  2. Oral birth control (estrogens)
  3. Prolonged bed rest
  4. IV fluids, rapid hydration, overhydration
Nursing Implications:
  1. Check the albumin level from the protein electrophoresis results. Many clinical problems are the result of a serum albumin deficit.
  2. Assess for peripheral edema in the lower extremities when the albumin level is decreased. Albumin is the major protein compound responsible for plasma colloid osmotic pressure. With a decreased albumin level, fluid seeps out of the blood vessels into the tissue spaces.
  3. Assess for urinary output. Renal and collagen (lupus) diseases occur with abnormal protein fractions. Urine output should be 25mL/h or 600mL/24 hours.
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