My nine year old son, diagnosed with type�1 diabetes 15 months ago, has had hemoglobin A1cs of 6.3%-7.4%, but he had protein in his urine (The nurse told me that his protein value was 30.) at his quarterly visit with his pediatric endocrinologist who ordered a repeat urine test. I do realize that each lab has its own “normal values”, but research via the Internet has found that less than 150 is considered normal. Do you think this number represents microalbumin? Is 30 considered high or low for microalbumin?

Your question shows how important it is when enquiring about a lab result to know both the ‘units’ in which the figures are given (e.g. mg/dl or mmol/l for glucose), and also the normal age appropriate range for that laboratory. These are required by law to be stated on the report.. So, it isn’t really possible to say what ’30’ means, but here are some widely accepted figures that you can refer to when you have the answers to the above:

Urine Albumin/Creatinine Ratio — Normal: 20 mg/gm on a random urine specimen. Note: It is of very little value simply to give Urine Albumin concentration as this varies widely according to how dilute the specimen is.
Albumin excretion rate on overnight urine collection — Normal: less than10 mcg/minute
Albumin excretion rate on a 24 hour urine collection — Normal: 15 mcg/minute

Having said all this, I should add that it is very unlikely indeed that your son’s proteinuria is due to his diabetes since he is only nine, has only been recently diagnosed and is in such excellent control. If the microalbumin turns out to be a little above the normal laboratory range, it might well be the result of a past mild glomerulonephritis that passed unrecognised clinically.

DOB

[Editor’s comment: See a previous question on this topic.

SS]