Microalbuminuria

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Name of Symptom/Sign:
Microalbuminuria
Classifications and external resources

ICD-10
ICD-9	791.0
MedlinePlus	003591

Microalbuminuria occurs when a malfunctioning kidney leaks small amounts of albumin into the urine.

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 filtered from the bloodstream by the kidneys.

Microalbuminuria is diagnosed either on 24-hour urine collections (20 to 200 µg/min) or, more commonly, if elevated concentrations (30 to 300mg/L) on at least two occasions.^[1]. Albumin levels above these values is called "macroalbuminuria", or sometimes just albuminuria.

To compensate for the variable possible urine concentration on spot-check samples, it is more typical in the UK to compare the amount of albumin in the sample against its concentration of creatinine. This is termed the Albumin/creatinine ratio (ACR) and microalbuminuria is defined as ACR ≥2.5 mg/mmol (male) or ≥3.5 mg/mmol(female).^[1]

Significance

• an indicator of subclinical cardiovascular disease
• marker of vascular endothelial dysfunction
• an important prognostic marker for kidney disease
  • in diabetes mellitus
  • in hypertension
• increasing microalbuminuria level during the first 48 hours after admission to an intensive care unit predicts elevated risk for acute respiratory failure , multiple organ failure , and overall mortality

References

• Abid O, Sun Q, Sugimoto K, Mercan D, Vincent JL (2001). "Predictive value of microalbuminuria in medical ICU patients: results of a pilot study". Chest 120 (6): 1984-8. PMID 11742932.

• 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. 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. 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. PMID 11565519.

Footnotes

See also

• albuminuria

External Links

• Online Microalbumin Urine Calculator

v • d • e Abnormal clinical and laboratory findings (R70-R94, 790-796)
Blood test	Red blood cells Elevated ESR - Anisocytosis - Poikilocytosis - Reticulocytosis - Inclusion bodies (Howell-Jolly body, Heinz body) Small molecules blood sugar: Abnormal glucose tolerance test - Hyperglycemia - Impaired glucose tolerance - Prediabetes other small molecules: Azotemia - Hyperuricemia Enzymes/other proteins Elevated transaminases - Cardiac marker - Elevated alpha-fetoprotein Minerals Iron overload disorder Pathogens/sepsis Bacteremia - Viremia - Fungemia - Parasitemia
Urine test	Proteinuria Albuminuria/Microalbuminuria - Myoglobinuria - Hemoglobinuria Small molecules Glycosuria - Ketonuria - Bilirubinuria Red blood cells Hematuria Other Chyluria - Crystalluria
Other	Abnormal basal metabolic rate - Latent tuberculosis

Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .