Microalbuminuria: Difference between revisions
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{{SignSymptom infobox | | {{SignSymptom infobox | | ||
Name = | Name = Microalbuminuria | | ||
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==Overview== | ==Overview== | ||
'''Microalbuminuria''' occurs when | '''Microalbuminuria''' occurs when the kidney leaks small amounts of [[human serum albumin|albumin]] into the urine, in other words, when there is an abnormally high [[permeability]]{{dn}} for albumin in the [[renal glomerulus]]. | ||
==Diagnosis== | ==Diagnosis== | ||
The level of albumin [[protein]] produced by | The level of albumin [[protein]] produced by microalbuminuria cannot be detected by urine [[dipstick]] methods. A [[microalbumin urine test]] determines the presence of the albumin in urine. In a properly functioning body, albumin is not normally present in urine because it is retained in the bloodstream by the kidneys. | ||
Microalbuminuria is diagnosed either | Microalbuminuria is diagnosed either from a 24-hour urine collection (between 30-300 mg/24 hours) or, more commonly, from elevated concentrations in a spot sample (30 to 300 mg/L). Both must be measured on at least two of three measurements over a two- to three-month period.<ref>{{cite web |url=http://meteor.aihw.gov.au/content/index.phtml/itemId/270336 |title=Person—microalbumin level (measured), total micrograms per minute N[NNN].N |accessdate=2007-07-05 |format= |work=}}</ref>. An albumin level above these values is called "macroalbuminuria", or sometimes just [[albuminuria]]. | ||
To compensate for | To compensate for variations in urine concentration in spot-check samples, it is more typical in the [[United Kingdom]] to compare the amount of albumin in the sample against its concentration of [[creatinine]]. This is termed the '''albumin/creatinine ratio''' ('''ACR''')<ref>PMID 10333950</ref> and microalbuminuria is defined as ACR ≥3.5 mg/mmol (female) or ≥2.5 mg/mmol(male),<ref>{{cite web |title=Proteinuria |date=December 15, 2005 |url=http://www.renal.org/eGFR/proteinuria.html |publisher= UK Renal Association}}</ref> or, with both substances measured by mass, as an ACR between 30 and 300 µg albumin/mg creatinine<ref>[http://www.clinlabnavigator.com/index.php?option=com_content&view=article&id=412:microalbumin&catid=35:test-interpretations clinlabnavigator.com > Test Interpretations] Last Updated on Saturday, 19 June 2010</ref>. | ||
==Significance== | ==Significance== | ||
* an indicator of subclinical cardiovascular disease | * Microalbuminuria is an indicator of subclinical cardiovascular disease | ||
* marker of vascular [[endothelial dysfunction]] | * Microalbuminuria is a marker of vascular [[endothelial dysfunction]] | ||
* an important prognostic marker for kidney disease | * Microalbuminuria is an important prognostic marker for kidney disease particularly in | ||
** | ** [[diabetes mellitus]] | ||
** | ** [[hypertension]] | ||
* | * Increasing microalbuminuria during the first 48 hours after admission to an [[intensive care unit]] is associated with an elevated risk for acute [[respiratory failure]], [[multiple organ failure]], and overall mortality | ||
* Microalbuminuria is a risk factor for [[venous thromboembolism]] <ref>http://www.ncbi.nlm.nih.gov/pubmed/19417196</ref> | |||
* | |||
< | |||
==See also== | ==See also== | ||
* [[albuminuria]] | * [[albuminuria]] | ||
{{ | ==References== | ||
{{reflist|2}} | |||
[[ | ==External links== | ||
* [http://www.pace-med-apps.com/uAlbCalc.htm Online Microalbumin Urine Calculator] | |||
* [http://www.roadmapstudy.org/ first-ever large-scale clinical trial to evaluate whether an ARB can prevent the initial development of Microalbuminuria] | |||
{{Abnormal clinical and laboratory findings for urine}} | |||
[[Category:Abnormal clinical and laboratory findings for urine]] | |||
[[Category:Nephrology]] | |||
[[Category: Medical tests]] | |||
Latest revision as of 17:24, 9 August 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Microalbuminuria occurs when the kidney leaks small amounts of albumin into the urine, in other words, when there is an abnormally high permeability[disambiguation needed] for albumin in the renal glomerulus.
Diagnosis
The level of albumin protein produced by microalbuminuria cannot be detected by urine dipstick methods. A microalbumin urine test determines the presence of the albumin in urine. In a properly functioning body, albumin is not normally present in urine because it is retained in the bloodstream by the kidneys.
Microalbuminuria is diagnosed either from a 24-hour urine collection (between 30-300 mg/24 hours) or, more commonly, from elevated concentrations in a spot sample (30 to 300 mg/L). Both must be measured on at least two of three measurements over a two- to three-month period.[1]. An albumin level above these values is called "macroalbuminuria", or sometimes just albuminuria.
To compensate for variations in urine concentration in spot-check samples, it is more typical in the United Kingdom to compare the amount of albumin in the sample against its concentration of creatinine. This is termed the albumin/creatinine ratio (ACR)[2] and microalbuminuria is defined as ACR ≥3.5 mg/mmol (female) or ≥2.5 mg/mmol(male),[3] or, with both substances measured by mass, as an ACR between 30 and 300 µg albumin/mg creatinine[4].
Significance
- Microalbuminuria is an indicator of subclinical cardiovascular disease
- Microalbuminuria is a marker of vascular endothelial dysfunction
- Microalbuminuria is an important prognostic marker for kidney disease particularly in
- Increasing microalbuminuria during the first 48 hours after admission to an intensive care unit is associated with an elevated risk for acute respiratory failure, multiple organ failure, and overall mortality
- Microalbuminuria is a risk factor for venous thromboembolism [5]
See also
References
- ↑ "Person—microalbumin level (measured), total micrograms per minute N[NNN].N". Retrieved 2007-07-05.
- ↑ PMID 10333950
- ↑ "Proteinuria". UK Renal Association. December 15, 2005.
- ↑ clinlabnavigator.com > Test Interpretations Last Updated on Saturday, 19 June 2010
- ↑ http://www.ncbi.nlm.nih.gov/pubmed/19417196