Microalbuminuria

Posted by e-Medical PPT
In the United States, microalbuminuria is found in 43%, and macroalbuminuria, in 8% of those with a history of diabetes.
Annual incidence rates of microalbuminuria of 1% to 2% are reported consistently for both type 1 and type 2 diabetes
Moreover, diabetes accounts for 45% of prevalent kidney failure, up from 18% in 1980.

Diabetic Kidney Disease (CKD)
Although kidney biopsy is required to diagnose diabetic glomerulopathy definitively, in most cases, careful screening of diabetic patients can identify people with DKD
DKD is based in part on the finding of elevated urinary albumin excretion, which is divided arbitrarily into:  microalbuminuria, a modest elevation of albumin thought to be associated with stable kidney function, but a greater risk of macroalbuminuria and kidney failure
 macroalbuminuria, a higher elevation of albumin associated with progressive decline in glomerular filtration rate (GFR), an increase in systemic blood pressure, and a high risk of kidney failure.

An elevated ACR should be confirmed in the absence of urinary tract infection with 2 additional first-void specimens collected during the next 3 to 6 months.
Microalbuminuria is defined as an ACR between 30-300 mg/g.
Macroalbuminuria is defined as an ACR > 300 mg/g.
2 of 3 samples should fall within the microalbuminuric or macroalbuminuric range to confirm classification.

In most patients with diabetes, CKD should be attributable to diabetes if:
Macroalbuminuria is present;  or
Microalbuminuria is present
In the presence of diabetic retinopathy
In type 1 diabetes of at least 10 years' duration.


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