From Kentucky, USA:
I am 48 years old and have had Type 1 diabetes for 43 years. I have always kept track of kidney function with serum creatinine (which have consistently been well within the normal range). My doctor wants me to have a microalbumin test done. Our local hospital lab is not familiar with the test. Could you tell me something about the test and, most importantly, how the results are interpreted?
The microalbumin test indicates whether there are very small amounts of protein in the urine. It can be measured on a random urine sample, but is more reliable if measured on an overnight collection of urine, or a 24-hour collection. If there are detectable amounts of microalbumin, the test must be repeated to verify the results before stating that the results are definite.
As you might expect, if there are detectable amounts of protein in the urine on repeated testing, the risk of future diabetic kidney disease is higher. But there's an added benefit of doing the test: if the microalbumin level is repeatedly elevated, it also warns of future macrovascular (large blood vessel) problems, such as heart attack and stroke. If the microalbumin levels are elevated, it is frequently advised to start a prescription medication in a class of medications called ACE-inhibitors, such as captopril or enalapril, which can delay the progression of the kidney impairment.
Also, I must point out that measurement of blood levels of creatinine, and/or urea nitrogen (usually called the BUN), are very insensitive methods of assessing kidney function, and that the microalbumin or urine protein levels typically are abnormal long before the creatinine and BUN become elevated from diabetic kidney disease.
Original posting 2 Nov 97
Updated January 16, 2006
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