What does a low albumin level of 1.8 on Liver Function Tests (LFT) indicate?

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Last updated: June 14, 2025View editorial policy

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From the Guidelines

A low albumin level of 1.8 g/dL on liver function tests indicates severe hypoalbuminemia, which is a serious medical condition requiring prompt medical attention. Normal albumin levels typically range from 3.5 to 5.0 g/dL, so a value of 1.8 is significantly below normal. This finding may indicate severe liver dysfunction, as the liver is the primary site of albumin production. However, hypoalbuminemia can also result from other conditions such as malnutrition, protein-losing enteropathy, nephrotic syndrome, or chronic inflammation. Patients with this level of albumin may experience symptoms like edema (swelling), particularly in the legs and abdomen, weakness, and fatigue.

Key Considerations

  • The liver is the primary site of albumin production, and low albumin levels can indicate liver dysfunction 1.
  • Hypoalbuminemia can also result from other conditions such as malnutrition, protein-losing enteropathy, nephrotic syndrome, or chronic inflammation 1.
  • Albumin infusions might be considered in some cases, but they address only the symptom rather than the cause of hypoalbuminemia 1.

Diagnostic Approach

  • Further diagnostic testing including complete liver function tests, kidney function tests, and possibly imaging studies is necessary to identify the underlying cause of hypoalbuminemia.
  • The patient's overall clinical status, including comorbid diseases, should be evaluated in the context of the low albumin level 1.

Treatment

  • Treatment depends on identifying and addressing the underlying cause of hypoalbuminemia.
  • Hospitalization, nutritional support, and specific treatments for the underlying disorder may be required.
  • Albumin infusions may be considered in select cases, such as spontaneous bacterial peritonitis or hepatorenal syndrome, but their use should be guided by evidence-based recommendations 1.

From the FDA Drug Label

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From the Research

Low Albumin Level on LFT

A low albumin level of 1.8 on Liver Function Tests (LFT) indicates impaired liver function. Albumin is a protein produced by the liver, and its level is used as a marker of liver health.

Implications of Low Albumin Level

  • Low albumin levels are associated with liver diseases such as non-alcoholic fatty liver disease (NAFLD), viral hepatitis, cirrhosis, and liver failure 2.
  • Impaired albumin function is associated with disease severity and prognosis, suggesting the concept of 'effective albumin concentration' 2, 3.
  • Albumin dysfunction may occur earlier than other conventional indicators of liver disease, making it a potential biomarker for early impairment in liver function 2.

Clinical Significance of Albumin Level

  • Albumin has various physiological functions beyond its oncotic properties, including molecular transport, anti-oxidation, anti-inflammation, endothelial stabilisation, and anti-thrombotic effects 4, 5.
  • Low serum albumin is common in cirrhosis and is associated with reduced survival, highlighting the importance of albumin in advanced liver disease 5.
  • Albumin administration may have benefits in patients with end-stage liver disease, including improving overall survival, reducing complications, and ameliorating quality of life 3, 5.

Factors Affecting Albumin Function

  • Post-translational modifications of albumin can alter its structure and function, leading to impaired albumin function in liver diseases 2, 3.
  • Exogenous and endogenous factors, such as oxidative damage and inflammation, can also affect albumin function 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

New Insights About Albumin and Liver Disease.

Annals of hepatology, 2018

Research

The role and indications of albumin in advanced liver disease.

Acta gastro-enterologica Belgica, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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