II. Indications
- Diabetes Mellitus
-
Hypertension
- Questionable efficacy as prognostic factor in Hypertension (contrast with Diabetes Mellitus)
III. Protocol
- Nephropathy diagnosis needs 2 of 3 samples positive
- Typically performed as a Urine Albumin to Creatinine Ratio (random spot urine collection)
- Consider postural Proteinuria (especially in adolescents)
- Obtain overnight timed urine collection
IV. Interpretation: Urine Albumin
- Normal (or mildly increased)
- 24h Collection: <30 mg/day
- Timed Collection: <20 mcg/min
- Urine Albumin to Creatinine Ratio (Spot Collection): <30 mcg/mg Creatinine
- Microalbuminuria (moderately increased)
- 24h Collection: 30-300 mg/day
- Timed Collection: 20-200 mcg/min
- Urine Albumin to Creatinine Ratio (Spot Collection): 30-300 mcg/mg Creatinine
- Macroalbuminuria (severely increased)
- 24h CollecSpot Collectiontion: >300 mg/day
- Timed Collection: >200 mcg/min
- Urine Albumin to Creatinine Ratio (Spot Collection): >300 mcg/mg Creatinine
V. Interpretation: Urine Albumin to Creatinine Ratio
- Preferred over Urine Protein to Creatinine Ratio
- Higher Test Sensitivity (esp. at lower albumin levels) than Urine Protein to Urine Creatinine Ratio
- Widespread standardization across lab assays and countries
- Normal Ratio (in general <30 mg/g is normal)
- Men: < 0.017 (or 17 mg albumin to 1 gram Creatinine)
- Women: <0.025 (or 25 mg albumin to 1 gram Creatinine)
- Microalbuminuria (moderately increased): 30-300 mg albumin/g Creatinine
- Macroalbuminuria (severely increased): >300 mg albumin/g Creatinine
- False Positive causes