Microalbuminuria in clinical practice.
Albumin excretion rate measured by new immunoassays and semiquantitative tests is advocated as a means for early detection of diabetic nephropathy. We determined albumin excretion rate in 276 patients. Albumin excretion rate was normal in 66%, within the microalbuminuric range in 27%, and within the macroproteinuric range in 7%. Significant predictors of albumin excretion rate included presence of hypertension and glycosylated hemoglobin level in type I diabetes mellitus, and years since diagnosis in type II diabetes mellitus. A semiquantitative test was deemed to be of limited diagnostic value. We conclude that testing for early diabetic nephropathy in routine clinical practice gives valuable information and that determination by a quantitative immunoassay based on a single 24-hour urine sample is preferable. The optimal frequency of screening and the levels that determine progressive renal disease have yet to be established.
McKenna
M J
MJ
Division of Endocrinology and Metabolism, Henry Ford Hospital, Detroit, Mich. 48202.
Arias
C
C
Feldkamp
C S
CS
Whitehouse
F W
FW
D000328:Adult; D000419:Albuminuria / Q000175:diagnosis* / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000652:urine; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay; D011933:Reagent Kits, Diagnostic
D011933:Reagent Kits, Diagnostic