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Microalbuminuria in Clinical Practice
Malachi J. McKenna, MD;
Cesar Arias, MD;
Carolyn S. Feldkamp, PhD;
Fred W. Whitehouse, MD
Arch Intern Med. 1991;151(9):1745-1747.
Abstract
Albumin excretion rate measured by new immunoassays and semiquantitative tests is advocated as a means for early detection of diabetic nephropathy. We determined albumin excretion rate in 276 patients. Albumin excretion rate was normal in 66%, within the microalbuminuric range in 27%, and within the macroproteinuric range in 7%. Significant predictors of albumin excretion rate included presence of hypertension and glycosylated hemoglobin level in type I diabetes mellitus, and years since diagnosis in type II diabetes mellitus. A semiquantitative test was deemed to be of limited diagnostic value. We conclude that testing for early diabetic nephropathy in routine clinical practice gives valuable information and that determination by a quantitative immunoassay based on a single 24-hour urine sample is preferable. The optimal frequency of screening and the levels that determine progressive renal disease have yet to be established.
(Arch Intern Med. 1991;151:1745-1747)
Author Affiliations
From the Division of Endocrinology and Metabolism (Drs Mc-Kenna, Arias, and Whitehouse), and the Radioligand Laboratory (Dr Feldkamp), Henry Ford Hospital, Detroit, Mich.
Footnotes
Accepted for publication April 8, 1991.
Reprint requests to Division of Endocrinology and Metabolism (K-16), Henry Ford Hospital, Detroit, MI 48202 (Dr Whitehouse).
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