Clinical Significance of Albumin Level Changes

Introduction to Albumin Significance

• A decrease in serum albumin of 0.1 g/dL or greater should be considered clinically significant, particularly when it occurs over a short time period, according to the American Journal of Kidney Diseases 1
• The American Journal of Kidney Diseases recommends that a difference of 0.1 g/dL in serum albumin concentration is associated with a 5% change in the risk of technique failure, 5% change in days hospitalized, and 6% change in the risk of death in peritoneal dialysis patients 1, 2

Interpretation of Albumin Changes

• The American Journal of Kidney Diseases suggests that serum albumin levels should be evaluated in the context of the patient's overall clinical status, including comorbid diseases 3
• The American Journal of Kidney Diseases states that normal serum albumin concentrations vary by laboratory methodology; hence local laboratory reference ranges should be used 1
• The American Journal of Kidney Diseases recommends that a stable or rising serum albumin concentration is more desirable than a declining one, even if both values are within normal range 1, 2

Monitoring and Goals

• The American Journal of Kidney Diseases recommends that serum albumin concentration should be monitored on a regular basis (at least every 4 months) 1
• The Diabetes Care journal suggests that for patients with chronic kidney disease with albuminuria >30 mg/g, monitoring should occur every 6 months 4
• The American Journal of Kidney Diseases states that the highest albumin level possible should be the goal for each patient 1

Causes and Pitfalls

• The American Journal of Kidney Diseases notes that catabolic illness can reduce albumin synthesis and increase albumin degradation, even with adequate dietary protein intake 1
• The American Journal of Kidney Diseases warns against overlooking the significance of small but progressive decreases in albumin levels 1