Hypoalbuminemia is the clinical term for a low level of albumin, a major protein circulating in the bloodstream. Albumin is synthesized exclusively by the liver and makes up about half of the total protein content in blood plasma. When albumin levels drop below the normal range, it often signals an underlying health condition, such as liver dysfunction, kidney disease, or severe inflammation.
The ICD-10 Code for Hypoalbuminemia
The International Classification of Diseases, 10th Revision (ICD-10), is the standardized system used globally to code and classify diagnoses and procedures. This system is necessary for medical billing, tracking disease prevalence, and reporting health data.
For hypoalbuminemia, the coding depends on whether an underlying cause has been identified. If documented as an isolated laboratory finding without a specified metabolic cause, the appropriate ICD-10 code is R77.0, signifying an abnormality of albumin. If the condition is specifically linked to a metabolic disturbance, the code E88.09, for “Other disorders of plasma-protein metabolism,” is applied.
Understanding Albumin and Its Functions
Albumin is a small, water-soluble protein that performs multiple roles in the body. Its most recognized function is maintaining oncotic pressure within the blood vessels, also known as colloid osmotic pressure. This pressure, generated primarily by albumin, draws fluid back into the capillaries, regulating water distribution and preventing excessive fluid from leaking into surrounding tissues.
Albumin also acts as a transport vehicle, binding to and carrying various substances throughout the circulation, including hormones, fatty acids, bilirubin, calcium, and many therapeutic drugs. Because of its high concentration, albumin also serves as a plasma buffer, helping to stabilize the blood’s pH level. Low albumin levels can affect the efficacy and safety of certain medications due to its role in drug transport.
Primary Causes and Associated Symptoms
Hypoalbuminemia generally stems from two main issues: impaired production or excessive loss of the protein. Since the liver is the sole site of synthesis, conditions that impair its function, such as cirrhosis or severe hepatitis, directly reduce albumin production. Severe malnutrition or inadequate protein intake can also hinder the liver’s ability to synthesize the protein.
Increased loss of albumin often involves the kidneys or the gastrointestinal tract. In kidney diseases like nephrotic syndrome, damaged filtering units allow large amounts of albumin to leak into the urine. Conditions causing protein-losing enteropathy, which damages the intestinal lining, can also lead to significant albumin loss through the digestive tract.
The most noticeable physical manifestation of low albumin is edema, or swelling, typically in the legs and feet. Reduced albumin concentration allows water to seep out of the capillaries and accumulate in surrounding tissues. This fluid accumulation can also manifest as ascites (fluid buildup in the abdomen) or effusions around internal organs.
Diagnostic Testing and Treatment Approaches
Hypoalbuminemia is confirmed through a blood test that measures the serum albumin level. For most adults, a normal serum albumin level ranges from 3.5 to 5.0 grams per deciliter (g/dL). A level consistently below this range is recognized as hypoalbuminemia, and levels below 2.5 g/dL are often considered severe.
Treatment primarily focuses on resolving the underlying cause rather than temporarily raising the protein level. For cases related to poor nutrition, dietary adjustments to increase protein intake are recommended to support liver synthesis. If the cause is kidney disease, managing the condition with medications, such as ACE inhibitors, can help reduce protein loss in the urine.
Managing conditions like liver disease or chronic inflammation requires specific medical interventions, allowing albumin levels to naturally improve. While intravenous albumin infusions can temporarily raise the level, especially for severe fluid imbalance, this approach does not treat the root problem. A comprehensive approach involves treating the primary disease, providing nutritional support, and managing associated fluid retention with diuretics.