ALBUMIN - plasma or serum

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Specimen: 5 mL blood in lithium heparin or plain tube. Avoid venous stasis. See Table 1 .

Method: Spectrophotometry, immunoassay.

Reference Interval: 32-45 g/L. Varies with age.

Application: Assessment of hydration, nutritional status, protein-losing disorders and liver disease.

Interpretation: Decreased levels may be associated with overhydration, chronic liver disease, protein losing disorders (eg nephrotic syndrome, protein-losing enteropathy), malnutrition, and shifts into the extravascular space (eg burns). Decreased levels may also be seen as part of an acute phase response. Increased levels may be seen with dehydration. Increases above the true level may occur with excessive use of tourniquet for sample collection, and with some methods that also measure acute phase reactants. Levels may be up to 15% higher if the specimen is collected with the patient erect, rather than supine. In severe hypoalbuminaemia, non-immunological methods significantly overestimate the level of albumin. See also Table 1 .

Reference: Whicher JT. In: Williams DL and Marks V eds. Biochemistry in Clinical Practice. Heinemann 1983.

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