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Diagnostic Tests: Urine Microalbumin
Overview — What This Test Is
Urine microalbumin testing detects small amounts of albumin in the urine that are not identified by standard urine dipstick testing. It is a highly sensitive screening test for early diabetic nephropathy, identifying kidney damage before overt proteinuria or decline in renal function occurs.
When to Answer Urine Microalbumin
You should choose urine microalbumin in a clinical scenario involving:
If a standard urine dipstick is already positive for protein, microalbumin testing is not necessary, as the disease has progressed beyond the microalbumin stage. In clinical practice, yearly screening with urine microalbumin is recommended for diabetic patients.
Treatment When the Test Is Positive
If microalbuminuria is detected, the treatment is aimed at preventing progression of diabetic kidney disease. The primary therapy is:
These medications reduce intraglomerular pressure and slow the progression of nephropathy, even in patients who are not hypertensive.
What Constitutes a Positive Test
Urine albumin excretion is interpreted as follows:
Overview — What This Test Is
Urine microalbumin testing detects small amounts of albumin in the urine that are not identified by standard urine dipstick testing. It is a highly sensitive screening test for early diabetic nephropathy, identifying kidney damage before overt proteinuria or decline in renal function occurs.
When to Answer Urine Microalbumin
You should choose urine microalbumin in a clinical scenario involving:
- Diabetes mellitus for more than 5 years
- Normal serum creatinine and normal GFR
- Negative routine urinalysis for protein
If a standard urine dipstick is already positive for protein, microalbumin testing is not necessary, as the disease has progressed beyond the microalbumin stage. In clinical practice, yearly screening with urine microalbumin is recommended for diabetic patients.
Treatment When the Test Is Positive
If microalbuminuria is detected, the treatment is aimed at preventing progression of diabetic kidney disease. The primary therapy is:
- ACE inhibitors or
- Angiotensin receptor blockers (ARBs)
These medications reduce intraglomerular pressure and slow the progression of nephropathy, even in patients who are not hypertensive.
What Constitutes a Positive Test
Urine albumin excretion is interpreted as follows:
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