Microalbuminuria

The term microalbuminuria is an unfortunate one since the albumin referred to is of normal molecular size and weight. Normal individuals excrete less than 30 μg of albumin per minute (43 mg in 24 hours). Dipsticks, however, detect albumin only in a concentration around 100 mg/L (150 mg per 24 hours if urine volume is normal).

An increase in albumin excretion between these two levels - so-called microalbuminuria - is now known to be an early indicator of diabetic glomerular disease. It is widely used as a predictor of the development of nephropathy in diabetics and may be extended to other conditions.

For example, the majority of patients with systemic lupus erythematosus but without overt renal disease have microalbuminuria and some ultimately develop clinically evident glomerulonephritis. By contrast, patients with minimal-change nephropathy after remission have normal albumin excretion.

Timed 24-hour urinary excretion rates provide the most precise measure of microalbuminuria. However, in clinical practice it is more convenient to test for microalbuminuria using random urine samples in which albumin concentration is related to urinary creatinine concentration. Kits are now available to test for microalbuminuria.

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Health Tip

Foods high in substances called purines increase levels of uric acid in the blood, and foods to be avoided include poultry, strawberries, shellfish, game, caffeine and alcohol.