This is a useful measure of kidney disease in diabetic renal disease.
First morning sample of urine is taken.
(Orthostatic proteinuria can be normal in young people – absent first thing in the morning but happens after walking around)
Microalbuminuria is defined as:
Albumin:Creatinine Ratio > 2.5mg/mmol in men
Albumin:Creatinine Ratio> 3.5mg/mmol in women
urinary albumin> 20mg/l
Urinary Albumin = 30 – 300mg / 24hours
Proteinuria is defined as:
Albumin:Creatinine Ratio > 30mg/mmol
Urinary albumin > 200mg/l
Urinary albumin 3.5g/24hours
So proteinuria is roughly 10 times the amount of microalbuminuria
Microalbuminuria preceeds persistent proteinuria which preceeds diabetic nephropathy and end-stage kidney disease.
End stage kidney disease
Antihypertensive medication slows this progression!!
There is an even stronger association between cardiovascular mortality and micro- and macro-albuminuria than end stage renal failure. Patients die of cardiovascular disease before renal failure has a chance to occur!!
- In type I diabetics – use an ACE-inhibitor should be used even if the patient is normotensive
- Control of blood pressure in these patients is of paramount importance.
- Tight glycaemic control is also really important – it’s been shown to slow renal disease.
- Addressing dyslipidemia and smoking are also vitally important.