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From Phoenix, Arizona, USA:

My eight year son, who has had typeá1 diabetes for 15 months, had a microalbumin of 26, and his hemoglobin A1c results have been 5.9-7.1%. He does experience some highs, but tests often enough that he is back in range fairly quickly. I see normal as less than 20 in adults. What is a normal microalbumin for children? Is this a fluke or a sign of beginning kidney problems?


Microalbumin means very small amounts of albumin protein. It is not a special type of albumin. I am not aware that there are differences in normal urinary microalbumin for children versus adults, but please be very careful about how the value is expressed:

One way is to report results the ratio of microalbumin relative to the amount of the urinary waste product called creatinine. This microalbumin/creatinine ratio should be less that 30 micrograms of microalbumin per milligram of creatinine. This is done in a random spot check. It is a screening test and only a screening test.

The other more sophisticated, but cumbersome, way is to carefully collect the urine over a 12 -24 hour time frame and then calculate the microalbumin excretion per minute of time collected. Several things can affect the amount of protein in the urine including fever, underlying kidney issues, and activity. So while the timed urine collection over 24 hours is the "gold standard", it is not always practical to do that. Many pediatric endocrinologists will then ask for a carefully timed and collected urine produced at night. (If the child is dry at night, then he empties his bladder in the toilet just before bed. Any and all urine produced during the night, including the urine collected first thing in the morning, would be collected in the special collection container.)

I think you need to know the answer to, "Why were they collecting urine for microalbumin in a prepubertal boy who has had diabetes for only a bit more than a year?" There may be very good reasons, but at this age, that's a bit more than current guidelines advise.


[Editor's comment: See a previous question on this topic, and the ISPAD Guidelines for microalbumin screening. SS]

Original posting 21 Nov 2001
Posted to Complications


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Last Updated: Tuesday April 06, 2010 15:09:28
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