Microalbuminuria
The excretion of daily urine is about one and half liters in an average adult. In this, the amount of protein excreted is always less than 300micro grams/liter. The portion of Albumin that is excreted in the urine is about less than 30 micrograms/liter.
Introduction
Diabetic nephropathy or kidney damage is one of the bitter truths of a diabetic life. This is dependent on the duration of diabetes, though the exact time after which the damage starts is not known. It is also difficult to pinpoint the onset even after the damage has started since the initial stages of the damage is almost asymptomatic, but the damaged relentless. So an acute need of a predictive and screening test was felt which fulfilled by the urinary test called as “Microalbuminuria”
This is a special urinary test in which the 24-hour urine or the random urine sample is tested for the amount of a protein called as the “Albumin”. This major component of our blood proteins is excreted in very little amounts in the urine, about less than 30 micrograms per day of urine.
Whom To Test For Microalbuminuria?
It has been proven that type 1 diabetics do not have microabuminuria till 5 years after diagnosis but type 2 diabetics are positive for the test at the time of diagnosis itself. So it is recommended that every type 2 diabetic at the time of diagnosis and type 1 diabetic after 15 years of diagnosis must have a urine albumin test.
When do we say the test is positive?
When the albumin excretion is 30 to 300 micrograms in 24-hour urinary sample or when is more than 30 mg per gram of creatinine in a random urine sample, then it is termed as Microalbuminuria. This is an indicator of the early damage to the kidneys called as Incipient proteinuria.
Methods Of Sample Collection
There are two ways in which the urine is to be collected: -
A. 24-Hour Urine Sample
This is an accurate way of measuring, but is tedious and is of long duration, requiring careful collection and preservation of urine for one whole day. Hence is not in much use now.
B. Random Urine Sample
In this a single urine sample is collected from the patient and tested for Albumin/Creatinine ratio, which gives the value of albumin excretion, though indirectly. Now days this is the most commonly used test.
What next if the test is negative?
The test needs to be repeated Annually, irrespective of the type of diabetes of the patient.
What if the test result is positive?
Then the diagnosis needs to be confirmed. A patient is said to be confirmed microabuminuric, if 2 out of 3 test results are positive in 3-6 months time. Then your health care provider guides you futher.
Can any other condition cause positive results?
Yes and such results are called false positive results, which have to be eliminated before confirming diabetic nephropathy as the cause of microabuminuria. The conditions that cause false positive results are
- Urinary tract infection
- Exercise just prior to the test
- Essential hypertension
- Major illnesses etc.
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Last
Modified : August 14, 2002. |
| Compiled and edited by
Editorial Team and approved by Expert Panel of DiabetoValens.com |
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