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Microalbumin test
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/microalbumin/MY00143
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Definition
A urine microalbumin test reveals important information about your kidneys.
Healthy kidneys filter waste products from your blood. If your kidneys become damaged, some of these waste products may remain in your blood. At the same time, a type of protein called albumin (al-BU-min) — which should stay in your blood — leaks into your urine. The microalbumin test detects this protein. Often, an elevated microalbumin level is the first sign of kidney damage.
Regular urine microalbumin tests are often recommended for people who have type 1 or type 2 diabetes. Urine microalbumin tests are also recommended for people who have high blood pressure (hypertension). Both diabetes and high blood pressure — among many possible causes — can damage the kidneys.
Why it's done
The urinary microalbumin test is a test designed as an early indication for kidney damage. The kidneys contain tiny blood vessel clusters that filter waste from your blood. Diabetes and high blood pressure can damage this delicate filtering system. Microalbumin tests can detect this damage at the earliest possible stages. Prompt treatment can help prevent kidney failure.
How often you need microalbumin tests depends on any underlying conditions and your risk of kidney damage. For example:
- Type 1 diabetes. If you have type 1 diabetes, your doctor may recommend a microalbumin test once a year beginning five years after your diagnosis.
- Type 2 diabetes. If you have type 2 diabetes, your doctor may recommend a microalbumin test once a year beginning immediately after your diagnosis.
- High blood pressure. If you have high blood pressure, your doctor may recommend regular microalbumin tests. The optimal screening schedule varies, so ask your doctor what's best for you.
If your urinary microalbumin level is elevated, your doctor may recommend more frequent testing. The earlier kidney problems are detected, the sooner you can begin treatment. If your kidneys fail, you'll need a kidney transplant or dialysis.
How you prepare
The microalbumin test is a simple urine test. You can eat and drink normally before the test.
What you can expect
During the microalbumin test, you simply need to provide a fresh urine sample. This may be done in several ways:
- 24-hour urine test. Your doctor may ask you to collect all of your urine in a special container over a 24-hour period and submit it for analysis. The 24-hour urine test provides the most accurate microalbumin results.
- Timed urine test. Your doctor may ask you to provide a urine sample first thing in the morning or after a four-hour period of not urinating.
- Random urine test. A urine sample provided at a random time is usually adequate if both microalbumin and creatinine — a waste product usually filtered by the kidneys — are measured.
The urine sample is sent to a lab for analysis. After you provide the urine sample, you can return to your usual activities immediately.
Results
Results of the microalbumin test are measured as milligrams (mg) of protein leakage. Generally:
- Less than 30 mg is normal.
- Thirty to 300 mg indicates early kidney disease (microalbuminuria).
- More than 300 mg indicates more advanced kidney disease (macroalbuminuria).
Keep in mind that target urinary microalbumin levels may change depending on many variables — including age, sex and testing method. It's also important to note that microalbumin levels can be affected by vigorous exercise, dehydration, blood in the urine, urinary tract infection and the use of certain drugs.
If your urinary microalbumin level is higher than normal, your doctor may want to confirm the results with a 24-hour urine test.
If kidney damage is a concern, your doctor may adjust your diabetes or high blood pressure treatment plan. Often an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) is prescribed to decrease the amount of protein in the urine. You can't undo kidney damage, but with appropriate treatment you may be able to prevent further damage.
- Microalbumin and microalbumin/creatinine ratio. American Association for Clinical Chemistry. http://www.labtestsonline.org/understanding/analytes/microalbumin/multiprint.html. Accessed June 7, 2010.
- McCulloch DK. Overview of medical care in adults with diabetes mellitus. http://www.uptodate.com/home/index.html. Accessed June 2, 2010.
- Rose BD, et al. Microalbuminuria and cardiovascular disease. http://www.uptodate.com/home/index.html. Accessed June 2, 2010.
- Prevent diabetes problems: Keep your kidneys healthy. National Diabetes Information Clearinghouse (NDIC). http://diabetes.niddk.nih.gov/dm/pubs/complications_kidneys/. Accessed June 7, 2010.
- Diabetes, kidney and cardiovascular disease. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=3044857. Accessed June 7, 2010.
- Israni AK, et al. Laboratory assessment of kidney disease: Clearance, urinalysis, and kidney biopsy. In: Brenner BM, et al. Brenner & Rector's The Kidney. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2008:724.
- Kidney disease (nephropathy). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html. Accessed June 8, 2010.
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