Microalbumin

Kidney

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No Fasting Required

Details

Measures small amounts of albumin in the urine

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Microalbumin Test Information Guide

Why is it done?
- The microalbumin test measures small amounts of albumin protein in the urine, which may indicate early kidney disease or damage
- Screening for diabetic nephropathy in patients with Type 1 or Type 2 diabetes mellitus
- Monitoring kidney function in patients with hypertension or cardiovascular disease risk factors
- Early detection of chronic kidney disease before significant renal function decline
- Routine screening during annual physical examinations in high-risk populations
- Assessing effectiveness of antihypertensive or diabetes medications on kidney protection
Normal Range
- Units of Measurement: mg/L (milligrams per liter) or μg/min (micrograms per minute)
- Normal/Negative Range: Less than 30 mg/24 hours or less than 20 μg/min (spot urine test: <2.5 mg/mmol in males, <3.5 mg/mmol in females)
- Microalbuminuria Range (Abnormal): 30-300 mg/24 hours or 20-200 μg/min (indicative of early kidney disease)
- Macroalbuminuria Range (Significant Abnormal): Greater than 300 mg/24 hours (indicates more advanced kidney disease or significant proteinuria)
- Interpretation Guide: Negative results indicate normal kidney function with minimal protein loss. Positive results suggest possible kidney damage requiring further evaluation and clinical correlation.
Interpretation
- Negative/Normal Results (<30 mg/24h): Indicates normal kidney function with no significant albumin loss. Kidneys are effectively filtering waste while retaining necessary proteins.
- Microalbuminuria (30-300 mg/24h): Suggests early-stage kidney disease or diabetic nephropathy. This is an important marker for increased cardiovascular risk and signals the need for intervention.
- Macroalbuminuria (>300 mg/24h): Indicates more advanced kidney disease, with significant proteinuria present. Associated with increased risk of progression to end-stage renal disease.
- Factors Affecting Results: Acute illness, fever, intense exercise, urinary tract infection, menstruation, and dehydration can temporarily elevate results. Confirmation testing is recommended for borderline values.
- Clinical Significance: Microalbuminuria in diabetic patients is a predictor of diabetic complications and an indicator that glycemic control may need optimization. In non-diabetic patients, it may indicate hypertensive kidney disease or early chronic kidney disease.
- Prognostic Value: Persistent microalbuminuria increases cardiovascular mortality risk, even in patients without overt kidney disease, making it an important marker for overall health monitoring.
Associated Organs
- Primary Organ System: Urinary and renal system (kidneys, glomeruli, renal filtration barrier)
- Diabetic Nephropathy: Most common cause of end-stage renal disease; develops in 20-40% of diabetic patients. Microalbuminuria is the first clinical sign of diabetic kidney damage.
- Hypertensive Kidney Disease: Chronic hypertension damages glomerular structure; microalbuminuria indicates hypertensive vascular and glomerular changes
- Chronic Kidney Disease (CKD): Microalbuminuria indicates Stage 1-3 CKD; signals progressive decline in glomerular filtration rate and need for renal protection strategies
- Associated Cardiovascular Risk: Microalbuminuria is associated with systemic endothelial dysfunction and increased risk of myocardial infarction, stroke, and cardiovascular death
- Potential Complications: Progression to overt proteinuria, rapidly declining renal function, hypertension exacerbation, fluid retention, electrolyte imbalances, and eventual renal failure requiring dialysis or transplantation
- Other Systemic Associations: Autoimmune diseases, metabolic syndrome, obesity, smoking, and genetic predisposition can contribute to development of microalbuminuria
Follow-up Tests
- Repeat Microalbumin Test: If initial result is borderline or abnormal, repeat testing after 1-2 weeks to confirm findings, as temporary elevations can occur
- 24-Hour Urine Protein: Quantifies total protein excretion to assess degree of proteinuria and help stage kidney disease severity
- Serum Creatinine and BUN: Assess glomerular filtration rate (GFR) and overall kidney function; repeated every 6-12 months in patients with microalbuminuria
- Estimated Glomerular Filtration Rate (eGFR): Calculated from serum creatinine; used to classify stage of chronic kidney disease and guide treatment decisions
- Basic Metabolic Panel (BMP): Evaluates electrolytes (sodium, potassium), glucose, and kidney function parameters; helps assess systemic effects
- Hemoglobin A1C: In diabetic patients, monitor 3-month average glucose control; better glycemic control may slow microalbuminuria progression
- Lipid Panel: Assess cholesterol and triglyceride levels; microalbuminuria is associated with dyslipidemia and increased cardiovascular risk
- Blood Pressure Monitoring: Regular monitoring and 24-hour ambulatory blood pressure assessment; hypertension control is critical to slow disease progression
- Renal Ultrasound: If significant kidney disease suspected; evaluates kidney size, structure, and rules out obstruction or other pathology
- Monitoring Frequency: Annual screening for at-risk populations; every 6 months if microalbuminuria confirmed; every 3 months if progressive disease or uncontrolled diabetes/hypertension
Fasting Required?
- Fasting Requirement: No - fasting is NOT required for microalbumin testing
- Sample Collection: Urine sample can be collected at any time of day. Options include 24-hour urine collection, spot urine sample, or timed collection (e.g., overnight or 4-hour)
- Optimal Collection Timing: First morning urine specimen is preferred due to higher albumin concentration and consistency of results
- Medications to Avoid: No medications need to be withheld. However, continue all regular medications as directed by your healthcare provider unless specifically instructed otherwise
- Pre-Test Preparation: Avoid strenuous exercise 24-48 hours before collection as intense physical activity can temporarily elevate urinary albumin. Avoid fever or acute illness.
- Special Instructions for Women: Avoid collection during menstruation or within 3 days after menstruation, as red blood cells can interfere with results
- Hydration Status: Maintain normal hydration patterns. Dehydration can concentrate urine and may falsely elevate results; excessive hydration can dilute results
- Container and Storage: Use sterile container provided by laboratory. For 24-hour collections, some labs may require preservative; follow specific instructions provided. Keep specimen cool and deliver promptly.

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