Testing for microalbuminuria in 2002: barriers to implementing current guidelines.
BACKGROUND
Testing for microalbuminuria is recommended to detect early kidney damage in patients with diabetes or other diseases. However, few studies have examined laboratory practices for microalbuminuria testing in the general community.


METHODS
In 2002, all laboratories in Montana and reference laboratories used by Montana laboratories for microalbuminuria measurement were surveyed by mail to ascertain if they provided testing for microalbuminuria, specific tests performed, and units and cutoff values used to report microalbuminuria results.


RESULTS
One hundred three of 126 laboratories (82%) responded to the survey. Overall, 79% of laboratories offered quantitative testing for microalbuminuria, either on site or through a reference laboratory. Twenty-five laboratories (24%) surveyed provided quantitative testing for microalbuminuria on site. Only 14 of 23 laboratories offering albumin-creatinine ratios on site reported results in units and cutoff values consistent with current recommendations. Fewer laboratories provided 24-hour (6 of 17 laboratories) or other timed (2 of 7 laboratories) testing, and many of these laboratories did not report results using recommended units and cutoff values. Overall, only 11 of 25 laboratories (44%) with on-site testing reported microalbuminuria values from 1 or more types of specimens exclusively using recommended units and cutoff values.


CONCLUSIONS
Quantitative testing for microalbuminuria is not offered universally, and results often are reported in units and cutoff values that differ from current clinical recommendations.
Harwell
Todd S
TS
Montana Department of Public Health and Human Services, Helena, MT 59620-2951, USA. tharwell@state.mt.us
Nelson
Robert G
RG
Little
Randie R
RR
McDowall
Janet M
JM
Helgerson
Steven D
SD
Gohdes
Dorothy
D
D000419:Albuminuria / Q000652:urine*; D003404:Creatinine / Q000652:urine; D003625:Data Collection; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007753:Laboratories / Q000592:standards / Q000706:statistics & numerical data*; D008832:Microchemistry; D009009:Montana; D017410:Practice Guidelines as Topic; D012015:Reference Standards
D003404:Creatinine