Microalbuminuria is a term used when minute amount of albumin is excreted in urine. It is an important indicator for kidney damage in diabetics. Medical practitioners recommend urine microalbuminuria test to measure albumin level in urine if they suspect kidney damage or the patient is likely to be at a risk of nephropathy, mainly caused due to diabetes.
Albumin is a type of protein. It is essential for maintenance and healthy growth of cells. Normally albumin is present in circulating blood. Its presence in urine indicates some type of damage to the kidneys.The prevalence of microalbuminuria is at least 50 to 60 percent in patient suffering from diabetes over 20 to 30 years. Since small quantity of urine protein is difficult to be detected with conventional urine test, a highly specific test is used to detect microalbuminuria. This test is called urine microalbuminuria test.
Causes Of Microalbuminuria
Kidney is important organ that removes waste products collected in the body. It filters out the waste through the circulating blood. It also maintains fluid level in the body. Healthy kidneys filter out the waste but it keeps the essential nutrients like albumin in the body.The two most common causes of kidney damage and the resultant microalbuminuria are diabetes and high blood pressure, especially when both or anyone of these conditions is present since long duration.
Physicians recommend doing urine microalbuminuria test to screen the health of kidney in patient suffering from these two diseases. Damage to kidneys due to diabetes is closely related to the severity and duration of hyperglycemia. Diabetes for more than 20 years and uncontrolled blood sugar are postulated to cause cellular damage to the infrastructure of kidneys. This leads to kidney dysfunction.A small quantity of albumin can be lost from the damaged kidney into the urine.
Physicians also rely on urine microalbuminuria test in patients suffering from high blood pressure to assess the function and health of kidney. High blood pressure can cause damage to the blood vessels of kidney. As a result small amount of albumin that is circulating in blood is leaked out and passes in the urine. Smoking and elevated LDL cholesterol level increases risk of hypertension and thus microalbuminuria.
Urine Microalbuminuria Test Procedure And Evaluation
The main purpose of microalbuminuria test is to measure amount of albumin in urine so that it becomes easy to assess kidney damage in diabetics at an early stage. This test is specific and sensitive which requires precision to detect very small amount of albumin that is released in urine. Normal urine test cannot detect small quantity of albumin passed in urine. Excretion of 30-300 mg of albumin in urine collected for 24 hours is considered as microalbuminuria. The result of the test is used and compared with creatinine test. Albumin to creatinine ratio is often measured instead of only urine albumin.
Microalbuminuria is diagnosed by collecting urine in a special jar provided by the health care provider. Whenever patient feels the urge, he is instructed to pass urine in this jar for 24 hours. After 24 hours the sample has to be returned to the health care provider for analysis of the urine. The lab will provide the result. The results normally are noted as; Less than 30 mg of protein which is considered to be normal. 30 to 300 mg of protein is considered to be microalbuminuria. Albumin excretion more than 300 mg is known as macroalbuminuria.
There are several other factors besides kidney damage due to diabetes and hypertension that can give rise to temporary microalbuminuria. This includes; blood in urine, strenuous exercise, dehydration, infection in urinary tract etc. Certain medications can also give rise to temporary microalbuminuria.
Guidelines For Treatment Of Microalbuminuria
After scrutinizing the results, if patient has microalbuminuria, the doctor will recommend treatment for kidney damage and the underlying factor responsible for it. Patients with persistent microalbuminuria need urine test every 6 months. The doctor makes every effort to achieve normal blood pressure and good sugar control.
Patient is usually prescribed anti hypertensive medicines even if the diabetic patient is normotensive. The patient is also advised to control his blood sugar level. It has become increasingly clear in recent time that good glycemic control indeed helps to prevent and postpone diabetic renal disease.