24 Hour Microalbumin Creatinine Ratio

Kidney

Report in 4Hrs

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No Fasting Required

Details

Measures albumin excretion in relation to creatinine over 24 hours.

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24 Hour Microalbumin Creatinine Ratio - Comprehensive Medical Test Guide

Why is it done?
- Test Purpose: Measures the amount of albumin (a protein) excreted in urine over a 24-hour period, adjusted for creatinine levels. This test detects microalbuminuria, which is the earliest sign of kidney damage and proteinuria.
- Primary Indications: Screen for early diabetic nephropathy; monitor kidney function in diabetic patients; assess risk of cardiovascular disease; evaluate patients with hypertension; detect glomerulonephritis; monitor chronic kidney disease progression.
- Typical Timing: Recommended annually for patients with type 1 or type 2 diabetes; at diagnosis and routinely for hypertensive patients; during baseline assessment for chronic kidney disease; when other kidney function tests show abnormalities.
Normal Range
- Reference Values: Normal (negative): Less than 30 mg/g creatinine per 24 hours or less than 3 mg/mmol creatinine
- Result Categories: Negative/Normal: <30 mg/g creatinine; Microalbuminuria (early kidney disease): 30-300 mg/g creatinine; Macroalbuminuria (significant proteinuria): >300 mg/g creatinine
- Units of Measurement: mg/g creatinine (milligrams albumin per gram creatinine) or mg/mmol creatinine (metric equivalent)
- Interpretation Overview: Normal results indicate healthy kidney function with minimal protein loss; borderline elevated results suggest early kidney damage requiring monitoring and intervention; significantly elevated results indicate advanced kidney disease or significant proteinuria.
Interpretation
- Normal Results (<30 mg/g creatinine): Indicates adequate kidney function with normal glomerular filtration; albumin is effectively retained by the kidneys; suggests no significant proteinuria or kidney damage present.
- Microalbuminuria (30-300 mg/g creatinine): Early stage kidney damage often associated with diabetes or hypertension; increased cardiovascular risk; indicates glomerular membrane dysfunction; requires close monitoring and intensive management of underlying conditions.
- Macroalbuminuria (>300 mg/g creatinine): Significant kidney disease with substantial protein loss; indicates advanced diabetic nephropathy or other glomerulonephritis; high risk for progression to kidney failure; requires aggressive therapeutic intervention.
- Factors Affecting Results: Urinary tract infections (may elevate temporarily); intense physical exercise (may cause transient elevation); fever or acute illness; blood in urine; menstruation (in females); dehydration; certain medications (ACE inhibitors, ARBs may lower values).
- Clinical Significance: Most sensitive marker for early diabetic kidney disease; strong predictor of cardiovascular events; helps guide treatment decisions and assess medication efficacy; indicates need for intensified blood pressure and glucose control.
Associated Organs
- Primary Organ System: Kidneys (renal system); specifically assesses function of the glomerulus (filtering unit of the kidney) and tubular reabsorption mechanisms.
- Associated Conditions: Type 1 and type 2 diabetes mellitus; hypertension; glomerulonephritis; lupus nephritis; immunoglobulin A nephropathy; polycystic kidney disease; chronic kidney disease (all stages); metabolic syndrome.
- Diseases Detected/Monitored: Diabetic nephropathy; hypertensive kidney disease; acute and chronic glomerulonephritis; kidney transplant rejection; medication-induced nephropathy; systemic lupus erythematosus with renal involvement; vasculitis affecting kidneys.
- Potential Complications: Progressive kidney disease leading to end-stage renal disease requiring dialysis; cardiovascular events (heart attack, stroke); hypertensive crisis; anemia from reduced erythropoietin production; bone disease from altered mineral metabolism; fluid overload and edema.
- Related Organ Systems: Cardiovascular system (affected by hypertension and kidney disease); endocrine system (diabetes influence); urinary system (bladder and urethra integrity); metabolic systems (electrolyte and acid-base balance).
Follow-up Tests
- Recommended Additional Tests: Serum creatinine (assess kidney function); blood urea nitrogen (BUN); estimated glomerular filtration rate (eGFR); urinalysis with microscopy; serum electrolytes (sodium, potassium, chloride); blood pressure monitoring.
- Further Investigations if Abnormal: Renal ultrasound or CT imaging; kidney biopsy (if diagnosis unclear); immunological testing (for autoimmune kidney disease); complement levels; antinuclear antibody (ANA) screening; blood glucose and HbA1c (if diabetic).
- Monitoring Frequency: Annually for stable diabetic patients without albuminuria; every 6 months if microalbuminuria present; every 3 months if macroalbuminuria present; more frequently (monthly or quarterly) if rapidly declining kidney function or new diagnosis.
- Complementary Tests: Lipid panel; liver function tests; complete blood count; phosphorus and calcium levels; parathyroid hormone (PTH); uric acid; cystatin C (alternative kidney function marker); repeat microalbumin creatinine ratio (confirm results and assess response to therapy).
- Therapeutic Response Monitoring: Repeat testing 4-12 weeks after starting ACE inhibitors or ARBs to assess effectiveness; follow-up after blood pressure or glucose management intensification; assess medication adherence and need for dosage adjustment.
Fasting Required?
- Fasting Status: No, fasting is NOT required for this test. This is a 24-hour urine collection test, not a blood test.
- Patient Preparation: No special fasting requirements; patient may eat and drink normally; maintain normal diet and fluid intake; continue taking all regular medications unless specifically instructed otherwise by physician.
- Collection Instructions: Begin collection first thing in morning by emptying bladder and discarding that urine; collect all urine for exactly 24 hours, including first void of next morning; use sterile container provided by laboratory; refrigerate container during collection; label with name, date, and time; deliver to laboratory on same day collection ends.
- Activities to Avoid: Avoid strenuous exercise during collection period (may elevate albumin temporarily); postpone if patient has active urinary tract infection (retest after antibiotics complete); avoid collection during menstruation if possible (reschedule collection); do not collect during fever or acute illness if possible.
- Medications: Continue all regular medications; inform healthcare provider of all medications being taken; ACE inhibitors and ARBs should NOT be discontinued before test; some medications may affect results (provide complete medication list to laboratory).
- Special Considerations: Ensure adequate hydration throughout collection period; maintain consistent daily routine; accurate timing is critical for valid results; request new container if old one is contaminated; report any difficulty with collection to laboratory.

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