What Is Albumin?

By Donna Swartzendruber, MSN, RN, CNN

Albumin is the most common protein found in the blood. It provides the body with the protein needed to both maintain growth and repair tissues. During a dialysis treatment, the albumin in your blood also helps with fluid removal. It helps "pull" extra fluid from swollen tissues back into the blood, where it can then be removed by the dialyzer.

Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines, from the National Kidney Foundation, recommend that a blood albumin level be 4.0 g/dl. or higher. That is also DaVita's recommendation.

What foods contain protein?

Foods from animals (e.g., beef, pork, fish, chicken, eggs, milk) contain the best sources of high quality protein. Lower quality protein comes from foods such as nuts, beans, vegetables and grain products. Your renal dietitian is an expert in knowing how much protein you should eat and also which foods are good sources of protein.

Some of these protein containing foods like milk, yogurt, cheese, nuts and beans may be limited in the dialysis diet because the potassium and phosphorus levels are too high for most dialysis patients to eat them on a regular basis or in normal portions.

Are there other causes of a low albumin besides not eating enough protein?

Inflammation and infection will cause an albumin level to drop. Possible causes of infections include an infected access, an infected foot, decayed teeth or infected gums or a bladder infection. Examples of long-term inflammations include arthritis and lupus.

Other non-dietary causes of a low albumin level include:

• Liver problems, such as from alcohol or from other liver diseases (albumin is synthesized in the liver)
• Metabolic acidosis
• With peritoneal dialysis (PD), protein loss across the peritoneal membrane

What can you do to help keep an adequate albumin level?

• Know what foods are good sources of protein and eat the amount recommended in your diet plan. Your dietitian is an excellent source of information.
• Help prevent infections (e.g., avoid scratching, keep your access clean).
• If you notice an area on your body that looks or feels infected (red, swollen, sore, possibly drainage), let your medical team know so that treatment can begin.
• Keep track of your albumin level. Know what your monthly blood levels are. If your albumin level is low, work with your medical team to determine the cause and come up with a solution.