Kidney Failure Risk Factor: Serum Albumin

Serum albumin is the main protein that's found in our blood. It's made in our liver, but we need a very good diet with enough protein to make the right amount. The normal level of albumin in the blood is 3.5 g/dL to 5 g/dL.

Serum albumin has many important jobs. It acts like a magnet in the blood to keep fluid in the right place throughout your body. When it's too low, you may get swelling from the build up of fluid in your feet, ankles, hands, around your eyes, lower back, or other parts of your body.

Albumin also carries important substances throughout the body, like hormones and drugs. So when serum albumin is low, these important products can't get to where they are needed in your body.

Serum albumin can be low in the blood for these reasons:

• Liver disease
• Extra fluid in your blood due to problems like heart failure. This extra fluid makes your albumin level seem low, even though it may be normal.
• Poor nutrition
• Stress, which can cause inflammation throughout your body.
• Losing albumin in the urine

Many studies have shown that chronic kidney disease (CKD) patients with a low serum albumin have an increased risk for reaching kidney failure as compared to patients with a normal serum albumin. The reasons for this are not completely understood, but experts have used studies to get an idea of why there's a link.

Some experts think that a low serum albumin is just a marker (type of sign in the blood) that shows the kidneys have been harmed. In other words, a low serum albumin only happens as a result of other underlying problems.

These underlying problems may include:

• Less albumin being made by the body and being broken down more quickly when nutrition is poor.
• Damaged kidneys that cause albumin to be lost in the urine, which is called albuminuria.

• Eat a well-balanced diet with the right amount of protein. But not only do you need enough protein from foods like eggs and nuts, you also need enough energy from carbohydrate foods like whole grain bread and rice.
• Control albuminuria. You healthcare team may tell you to take a special type of blood pressure medicine, either an ACEi (angiotensin converting enzyme inhibitor) or an ARB (angiotensin receptor blocker). You should also follow a diet low in salt and sodium.
• Control fluid build-up in your body. Your healthcare team may tell you to take a drug called a diuretic to remove extra fluid in your body. You should also follow a diet low in salt and sodium.
• Make sure that your healthcare team has checked your liver.
• Your healthcare team may tell you to take dietary supplements that give you extra protein and calories.
• Depending on the reason for your low serum albumin, your healthcare team may give you albumin through a needle in a vein (IV albumin).

For more information:

• Speak with your healthcare team
• Visit the National Kidney Foundation at www.kidney.org