- The sample is urine.
- It is better to do three random samples for a week.
- The urine sample is stable at room temperature for up to 2 days and at 8 °C for up to 14 days.
- This is advised in a diabetic patient to rule out diabetic nephropathy.
- Microalbumin is a misnomer. This does not refer to any different form of albumin, but instead, there is a small amount of albumin excreted in the urine.
- This is defined as excretion of 30 – 150 µg/min protein in the urine and not detected by dipsticks, but can be measured by sensitive methods.
- If there is increased urinary albumin excretion that is predictive of diabetic nephropathy and also known as microalbuminuria.
- Normally the small amount is excreted by the glomeruli which are reabsorbed by the tubules.
- When the disease increases the albumin excreted by the glomeruli is more than reabsorbed by the tubule will lead to microalbuminuria which is not detected by the ordinary methods.
- This urinary albumin excretion precedes and highly indicative of diabetic nephropathy and is called microalbuminuria.
- Early detection of microalbumin may predict end-stage renal nephropathies with Diabetes type 1, (IDDM) patients.
- This test is useful for the diagnosis of Angiopathic changes in diabetic patients before gross proteinuria is seen.
- Evidence suggests that lowering of blood pressure and control of hyperglycemia will alter the course of the disease and prevents irreversible nephropathy.
- Microalbuminuria is the first sign of diabetes complications like:
- Diabetic nephropathy.
- cardiovascular disease.
- Diabetic patients with microalbuminuria have 5 to 10 times more chances for cardiovascular mortality, retinopathy, and end-stage kidney.
- The presence of microalbuminuria in nondiabetic patients is an indicator of lower life expectancy because of hypertension and cardiovascular disease risk.
- Nondiabetic nephropathies may show microalbuminuria.
Recommendations for microalbuminuria seen in diabetic patients are:
- Diabetic patients should have an annual checkup of microalbuminuria.
- Albumin in urine < 30 mg/24 hours
- Or < 20 mg/day.
- Or < 20 mg/L (urine collected in 10 hours).
- 0.2 to 1.9 mg/dL
- Albumin > 30 mg/24 hours .
- Or > 20 mg/L (in 10 hours).
limits with various dipsticks:
- Albusure 2 to 3 mg/dl
- Micral 1.5 to 2 mg/dl
- Micro-Burnintest 4 to 8 mg/dl
Microalbuminuria is seen in:
- Diabetes mellitus.
- Nephrotoxic drugs.
- Bence-Jones proteinuria.
- Any kind of Nephropathy.
- Myocardial infarction.
- Atherosclerosis ( Generalized vascular disease ).
- Lipid abnormalities.