The prealbumin test is used to help your doctor diagnose problems with your nutrition. Prealbumin most often is used to help doctors diagnose protein-calorie malnutrition. In this condition, which can affect more than 30% of hospitalized patients, the body breaks down muscle, protein, and body fat. This type of malnutrition can lead to complications and even death if not treated. Children with malnutrition may fail to thrive or have stunted growth.

The test is also used to make an assessment of nutritional status:

• before a scheduled surgery,
• in patients who are hospitalized with certain conditions, and
• in patients who are chronically ill.

Many patients have a decline in nutrition during their hospital stay, especially after surgery. Studies have shown that good nutrition prior to surgery helps to avoid complications, such as pneumonia and infection, after surgery. If the prealbumin test indicates that you are malnourished or have poor nutrition, your doctor can help correct your diet so you get stronger before your surgery. Albumin may be tested instead to determine nutritional status.

The test also is used to monitor changes in patients who are receiving parenteral nutrition (nutrition from outside of the gastrointestinal tract, such as nutrients given through intravenous treatment). The test also is used to monitor changes in nutrition status for patients who are receiving hemodialysis, a process that removes waste substances from your circulating blood. Hemodialysis is part of treatment for patients with kidney disease.

A doctor orders a prealbumin test when signs of malnutrition or poor nutrition are present. Signs of malnutrition include extreme weight loss, stunted growth (in a child), weakened resistance to infection, or being unable to think clearly. Hair may become brittle or begin to fall out, the skin may be dry or yellowish, muscles may feel weak, and fainting spells may occur. In younger women, menstrual periods may stop.

Generally, a prealbumin or albumin test will be ordered prior to surgery or when a patient is being treated for certain conditions. Doctors may also order the test regularly to monitor patients who have had low prealbumin results. Monitoring will be more or less frequent, depending on the test results.

The prealbumin measurement reflects the state of your nutrition. If prealbumin is low, other proteins and substances in your blood also may be low.

If your test shows that prealbumin is low, your nutrition probably needs to be corrected. If prealbumin is very low, you may be considered malnourished and need immediate medical attention. Lower levels of prealbumin may be seen in patients with:

• severe or chronic illness, such as cancer;
• hyperthyroidism;
• liver disease;
• serious infections; and 
• certain digestive disorders.

If a patient has inflammation, however, it is impossible to know exactly what the prealbumin value means. When inflammation and malnutrition are both present, prealbumin levels fall very far, very quickly.

Higher levels of prealbumin are common in patients with:

• high-dose corticosteroid therapy;
• hyperactive adrenal glands;
• high-dose nonsteroidal anti-inflammatory medications; and
• Hodgkin’s disease.

If a patient is in renal failure, prealbumin results may be falsely higher than they actually are.

Inflammation can interfere with the results of your prealbumin test, causing it to be lower than it would be. Certain drugs can also lower your prealbumin level, including amiodarone, estrogens, and oral contraceptives (birth control pills).

Drugs that can cause your prealbumin level to rise in your blood are anabolic steroids, androgens (male hormones), and prednisolone.

Recent research has shown that the prealbumin test can predict poor outcomes for hemodialysis patients. A low initial reading (baseline level) of prealbumin predicts that a patient may have problems, and steadily dropping prealbumin values are associated with low survival.