Microalbuminuria (MA) is referred to as a slight rise in the amount of urine albumin. It happens when the kidney leaks tiny quantities of albumin into the urine, or when the glomerulus of the kidney has an excessively high permeability for albumin. Albumin is normally filtered out of the blood by the kidneys and passed in the urine. When the filtering capacity of the kidneys is damaged, albumin begins to leak into the urine.
Diagnosis:
- Special albumin-specific urine dipsticks, specialized tests which have a lower detection threshold than regular urine dipsticks, can detect the quantity of albumin protein generated by microalbuminuria.
- The presence of albumin in the urine is determined by a microalbumin urine test. Albumin is generally not seen in urine in a healthy organism because it is kept in circulation by the kidneys.
- A 24-hour urine collection (between 30–300 mg/24 hours) or, more typically, an increased concentration in a spot sample (20 to 200 mg/l) can be used to diagnose microalbuminuria. Over a two- to three-month period, both must be measured on at least two of three occasions.
- Microalbuminuria is also defined as albumin creatinine ratio(ACR) of 3.5 mg/mmol (female) or 2.5 mg/mmol (male) or an ACR of 30 to 300 g albumin/mg creatinine when both substances are determined by mass.
- Macroalbuminuria, or simply albuminuria, is defined as an albumin level that exceeds the upper limit values(>300mg/24hrs).
Microalbuminuria Causes and 3 deadly Implications:
- Microalbuminuria is a marker of vascular endothelial dysfunction.
- An important prognostic marker for kidney disease in diabetes mellitus, hypertension,in post-streptococcal glomerulonephritis.
- Increasing microalbuminuria during the first 48 hours after admission to an intensive care unit predicts an increased risk of acute respiratory failure, multiple organ failure, and overall mortality.
- A diet heavy in animal protein, animal fat, and cholesterol may increase the risk of microalbuminuria, whereas a diet rich in fruits, vegetables, and whole grains but low in meat and sweets may preserve renal function.
- Microalbuminuria is a risk factor for venous thromboembolism.
- Microalbuminuria is an early sign of diabetic nephropathy, a serious complication of diabetes. People with diabetes who have MA are at risk for developing diabetic nephropathy. This is a serious kidney disease that can lead to kidney failure. Early detection and treatment of MA can help prevent or delay the development of diabetic nephropathy.
References:
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- Andersen S, Blouch K, Bialek J, Deckert M, Parving HH, Myers BD (2000). “Glomerular permselectivity in early stages of overt diabetic nephropathy”. Kidney Int. 58 (5): 2129–37. doi:10.1111/j.1523-1755.2000.00386.x. PMID 11044234.
- Heart Outcomes Prevention Evaluation Study Investigators (2000). “Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy”. Lancet. 355 (9200): 253–9. doi:10.1016/S0140-6736(99)12323-7. PMID 10675071.
- Lemley KV, Abdullah I, Myers BD, et al. (2000). “Evolution of incipient nephropathy in type 2 diabetes mellitus”. Kidney Int. 58 (3): 1228–37. doi:10.1046/j.1523-1755.2000.00223.x. PMID 10972685.
- Lièvre M, Marre M, Chatellier G, et al. (2000). “The non-insulin-dependent diabetes, hypertension, microalbuminuria or proteinuria, cardiovascular events, and ramipril (DIABHYCAR) study: design, organization, and patient recruitment. DIABHYCAR Study Group”. Controlled Clinical Trials. 21 (4): 383–96. doi:10.1016/S0197-2456(00)00060-X. PMID 10913814.
- Parving HH, Lehnert H, Bröchner-Mortensen J, Gomis R, Andersen S, Arner P (2001). “The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes”. N. Engl. J. Med. 345 (12): 870–8. doi:10.1056/NEJMoa011489. PMID 11565519.
- Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney inter., Suppl. 2013; 3: 1–150.
