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Albumin in urine
Last reviewed: 19.11.2021
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A study for microalbuminuria (urine albumin assay) is used to screen for kidney lesions, particularly diabetic nephropathy, which significantly reduces costs and improves the prognosis of terminal chronic renal failure.
The frequency of diabetic nephropathy is 40-50% in patients with type 1 diabetes mellitus and 15-30% in patients with type 2 diabetes mellitus. The danger of this complication is that it develops slowly and gradually, therefore for a long time it remains unnoticed. The earliest sign of diabetic nephropathy (before the appearance of proteinuria) is microalbuminuria. Microalbuminuria is the excretion of albumin in the urine, exceeding the permissible normal values, but not reaching the degree of proteinuria. Normally, no more than 30 mg of albumin is excreted per day, which is equivalent to a concentration of albumin in the urine of less than 20 mg / l in its one-time analysis. With proteinuria, excretion of albumin with urine exceeds 300 mg / day. Thus, the range of fluctuations in albumin concentration in urine with microalbuminuria is 30 to 300 mg / day or 20 to 200 μg / min. The appearance of a permanent microalbuminuria in a patient with diabetes mellitus testifies to the likely development (during the next 5-7 years) of a marked stage of diabetic nephropathy.
Another early marker of diabetic nephropathy is impaired intracellular hemodynamics (hyperfiltration, kidney hyperperfusion). Hyperfiltration is characterized by an increase in the glomerular filtration rate (GFR) above 140 ml / min. To determine GFR, a Reberg-Tareev test is used, based on a study of the clearance of endogenous creatinine.
Classification of albuminuria
|
Albumin excretion in urine |
Concentration | ||
|
Type of albuminuria |
With a one-time collection of urine, μg / min |
Per day, mg |
Albumin in urine, mg / l |
|
Normoalbuminuria Microalbuminuria Macroalbuminuria |
Less than 20 20-200 More than 200 |
Less than 30 30-300 More than 300 |
Less than 20 20-200 More than 200 |
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