Test Catalog

Test Id : ALBFL

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Albumin, Body Fluid

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Aiding in identifying the cause of ascites

 

Aiding in differentiating exudative and transudative pleural effusions

Method Name
A short description of the method used to perform the test

Colorimetric

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Albumin, BF

Aliases
Lists additional common names for a test, as an aid in searching

SAAG

Serum ascites albumin gradient

Specimen Type
Describes the specimen type validated for testing

Body Fluid

Ordering Guidance

For cerebrospinal fluid (CSF) specimens, order ALBSF / Albumin, Spinal Fluid. Testing will be changed to ALBSF if this test is ordered on that specimen type.

Necessary Information

1. Date and time of collection are required.

2. Specimen source is required.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
797FL Fluid Type, Albumin

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Specimen Type: Body fluid

Preferred Source:

-Peritoneal fluid (peritoneal, abdominal, ascites, paracentesis)

-Pleural fluid (pleural, chest, thoracentesis)

-Drain fluid (drainage, JP drain)

Acceptable Source: Write in source name with source location (if appropriate)

Collection Container/Tube: Sterile container

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL

Collection Instructions:

1. Centrifuge to remove any cellular material and transfer into a plastic vial.

2. Indicate the specimen source and source location on label.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Gross Icterus Reject
Anticoagulant or additive
Breast milk
Nasal secretions
Gastric secretions
Bronchoalveolar lavage (BAL) or bronchial washings
Colostomy/ostomy
Feces
Urine
Saliva
Sputum
Vitreous fluid 		Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Body Fluid Refrigerated (preferred) 7 days
Frozen 30 days
Ambient 24 hours

Useful For
Suggests clinical disorders or settings where the test may be helpful

Aiding in identifying the cause of ascites

 

Aiding in differentiating exudative and transudative pleural effusions

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Peritoneal fluid:

Ascites is the pathologic accumulation of excess fluid in the peritoneal cavity caused by changes in vascular permeability, hydrostatic pressure, and oncotic pressure. The most common causes of ascites in individuals are cirrhosis (80%), malignancy (10%), cardiac failure (5%), and infection.

 

Total protein results of 3.0 g/dL or greater, historically used to classify ascites fluid as transudate or exudate, has a reported accuracy of only 55% in identifying exudates and has been largely replaced with measurement of the serum-ascites albumin gradient (SAAG), calculated as serum albumin concentration minus ascites albumin concentration.

 

SAAG has been shown to correlate directly with portal pressure and SAAG results of 1.1 g/dL or greater are 97% accurate at identifying portal hypertension. Conditions associated with high SAAG include cirrhosis, acute liver failure, fatty liver disease, alcoholic hepatitis, portal vein thrombosis, hepatic malignancy, and veno-occlusive disease. Cardiac ascitic fluid caused by congestive heart failure has both a high SAAG result (> or =1.1 g/dL) and total protein concentration greater than 2.5 g/dL. Conditions associated with low SAAG measurement (<1.1 g/dL) include peritoneal malignancy, tuberculosis, pancreatitis, connective tissue disease, and nephrotic syndrome.

 

Pleural fluid:

Pleural fluid is normally present within the pleural cavity surrounding the lungs, serving as a lubricant between the lungs and inner chest wall. Pleural effusion develops when the pleural cavity experiences an overproduction of fluid due to increased capillary hydrostatic and osmotic pressure that exceeds the ability of the lymphatic or venous system to return the fluid to circulation. Laboratory-based criteria are often used to classify pleural effusions as either exudative or transudative. Exudative effusions form due to infection or inflammation of the capillary membranes allowing excess fluid into the pleural cavity. Patients with these conditions benefit from further investigation and treatment of the local cause of inflammation. Transudative effusions form due to systemic conditions such as volume overload, end-stage renal disease, and heart failure that can lead to excess fluid accumulation in the pleural cavity. Patients with transudative effusions benefit from treatment of the underlying condition.(1) Dr. Richard Light derived criteria in the 1970s for patients with pleural effusions that are still used today.(2) Dr. Light's criteria were designed to be sensitive for detecting exudates at the expense of specificity.(3) Heart failure and recent diuretic use contribute to most misclassifications by Dr. Light's criteria (transudates falsely categorized as exudates). Serum-to-fluid protein or albumin gradient (serum protein or albumin minus fluid protein or albumin) may be calculated in these cases and when more than 3.1 g/dL (protein) or 1.2 g/dL (albumin) suggests the patient has a transudative effusion.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

An interpretive report will be provided

Interpretation
Provides information to assist in interpretation of the test results

Peritoneal fluid albumin is used to calculate the serum-ascites albumin gradient. Values of 1.1 g/dL or higher suggest portal hypertension.

 

Pleural fluid albumin may be used to calculate a serum-effusion albumin gradient. Values above 1.2 g/dL are most consistent with a transudative process.

 

For all other fluids, the albumin concentration and gradient have only been evaluated in peritoneal and pleural fluids. All other fluid albumin concentrations should be interpreted in conjunction with serum albumin concentration and other clinical findings.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Serum and ascitic fluid for determination of serum-albumin ascites gradient should be collected on the same day.

 

In very rare cases of gammopathy, in particular type IgM (Waldenstrom macroglobulinemia), (may cause unreliable results.

 

Colorimetric methods used for the determination of albumin may lead to falsely elevated test results in patients suffering from renal failure or insufficiency due to interference with other proteins. Immunoturbidimetric methods are less affected.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Runyon BA, Montano AA, Akriviadis EA, Antillon MR, Irving MA, McHutchison JG. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med. 1992;117(3):215-220. doi:10.7326/0003-4819-117-3-215

2. Clinical and Laboratory Standards Institute: Analysis of Body Fluids in Clinical Chemistry; Approved Guideline. CLSI document C49-A (ISBN 1-56238-638-7). Clinical and Laboratory Standards Institute, 2007

3. Block DR, Algeciras-Schimnich A. Body fluid analysis: Clinical utility and applicability of published studies to guide interpretation of today's laboratory testing in serous fluids. Crit Rev Clin Lab Sci. 2013; 50(4-5):107-124

4. Heffner JE, Brown LK, Barbieri CA. Diagnostic value of tests that discriminate between exudative and transudative pleural effusions. Chest. 1997;111(4):970-980

5. Du L, Wei N, Maiwall R, Song Y. Differential diagnosis of ascites: etiologies, ascitic fluid analysis, diagnostic algorithm. ClinChem Lab Med.. 2023;62(7):1266-1276. Published 2023 Dec 20. doi:10.1515/cclm-2023-1112

Method Description
Describes how the test is performed and provides a method-specific reference

The dye, bromcresol green (BCG), is added to the sample in an acid buffer. The color intensity of the blue-green albumin-BCG complex is directly proportional to the albumin concentration and is determined photometrically.(Package insert: Albumin reagent. Roche Diagnostic; V 11.0, 02/2022)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Sunday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

Same day/1 to 2 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

1 week

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been modified from the manufacturer's instructions. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82042

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
ALBFL Albumin, BF 1747-5
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
ALBF Albumin BF 1747-5
797FL Fluid Type, Albumin 14725-6

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports