Update on microalbuminuria as a biomarker in renal and cardiovascular disease.
OBJECTIVE
To discuss recently published papers on the potential use of albuminuria as a predictor of cardiovascular and renal disease.


RESULTS
Recent studies indicate that screening for microalbuminuria may not only be beneficial for detection and prevention of cardiovascular and renal disease in patients with diabetes, but also in the general population. The best method for this, however, is not yet clear. Findings indicate that it is preferable to assess albumin concentration in fresh urine samples rather than in samples that have been frozen. Furthermore, a new assay for albumin assessment has become available, which detects previously undetectable immuno-unreactive albumin above and beyond immunoreactive albumin detected by classic immunochemical assays. The pros and cons of this assay are considered.


CONCLUSIONS
Urinary albumin is a cheap, noninvasive, and easily assessable risk marker, that does not per se require a visit to a physician or health center. As such, it is a promising candidate for screening to identify subjects at high risk of cardiovascular and renal disease, even if albuminuria is not shown to be independent of other risk markers.
Lambers Heerspink
Hiddo J
HJ
Department of Clinical Pharmacology, The Netherlands bDepartment of Internal Medicine, The Netherlands. h.j.lambers.heerspink@med.umcg.nl
Brinkman
Jacoline W
JW
Bakker
Stephan J L
SJ
Gansevoort
Ron T
RT
de Zeeuw
Dick
D
D000418:Albumins / Q000032:analysis*; D000419:Albuminuria / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D002851:Chromatography, High Pressure Liquid; D006801:Humans; D007120:Immunochemistry; D007674:Kidney Diseases / Q000175:diagnosis*; D008991:Monitoring, Physiologic; D013048:Specimen Handling
D000418:Albumins; D015415:Biomarkers