Albuminuria Factsheet PDF, 0.12Mb

Total Page:16

File Type:pdf, Size:1020Kb

Albuminuria Factsheet PDF, 0.12Mb Last Reviewed July 2015 Page 1 Prevent, Detect, Support. Fact sheet Albuminuria What is albuminuria? What is proteinuria? Albumin is a protein in your blood. If your kidneys are damaged and Albuminuria and proteinuria mean In the blood, albumin acts as a carrier albumin leaks into the urine in very similar things. Albuminuria refers and helps to maintain blood volume small or ‘micro’ amounts, this is called to abnormal levels of the protein and pressure. The action of the kidney microalbuminuria. As kidney function called albumin in your urine. While is to filter the blood to remove waste declines the amount of albumin in the albumin is the most common protein products and these filters (known as urine increases, and larger or ‘macro’ found in the urine, there are other glomeruli) prevent large molecules, amounts of albumin may be present. proteins in the urine such as low such as albumin, from passing This is known as macroalbuminuria. molecular weight immunoglobulin, through. If these filters are damaged, lysozyme, insulin and beta-2 The finding of albumin in the urine albumin passes from the blood in microglobulin. Proteinuria refers to may be the first sign of an otherwise to the urine. abnormal levels of all of the proteins silent kidney condition. in the urine, which may or may not include albumin. What causes albuminuria? What is orthostatic proteinuria? Inflammation or swelling of the kidney Cardiovascular disease is also linked filters is the most common cause of with albuminuria. Damaged blood Sometimes older children have albuminuria. This condition is often vessels may lead to heart failure or orthostatic proteinuria. It is unusual called glomerulonephritis or nephritis. stroke as well as kidney failure. Some in people aged over 30. ‘Orthostatic’ See the ‘Nephritis’ fact sheet for more examples of temporary albuminuria means upright so protein is only lost information. that are often not a sign of significant into the urine when these children kidney damage include: Diabetes and high blood pressure are standing up. Children with this are the two main risk factors for • when it follows strenuous exercise kidney condition do not have kidney albuminuria as they can damage your damage and for reasons that are not • when it only occurs with a fever kidney filters. Older age, weight gain understood, only have proteinuria and certain family backgrounds can • when it occurs only during a urinary when they are active. also increase the risk. tract infection • when it is absent in the morning but occurs later in the day, called orthostatic proteinuria Connect with us www.kidney.org.au Freecall 1800 454 363 Kidney Health Australia Albuminuria Last Reviewed July 2015 Prevent, Detect, Support. Page 2 What are the symptoms of albuminuria? In some cases there may be no vessel walls and causes swelling of early signs of chronic kidney disease signs or symptoms linked with this soft tissue areas such as around the (CKD) that can worsen over time. condition. One of the most common eyes and other body parts like the Sometimes there is a large amount symptoms of albuminuria is foamy feet and hands. of protein present yet the underlying appearance or excessive frothing problem may be treatable. Ongoing The amount and type of protein in of the urine. albuminuria usually indicates the the urine reflects the change that presence of serious, underlying kidney When a very high level of albuminuria has occurred to the kidney. A small disease so albuminuria should always is ongoing, it may cause the protein amount of albuminuria that comes be investigated. in your blood to drop. This drop allows and goes is usually not significant fluid to move through the blood but sometimes these low levels are What tests detect albuminuria? The preferred method for detecting years if you are obese, smoke, have albuminuria is a test called a urinary cardiovascular disease, have a family albumin:creatinine ratio (urine ACR). history of CKD or are of Aboriginal or This test is performed on a single Torres Strait Islander origin. sample of your urine. Your doctor may Your doctor will also probably suggest ask you to collect a urine sample first you have a blood test to detect the thing in the morning, right after you possible causes for loss of protein. get up (called a first void sample). If this is not practical, your doctor can If the doctor suspects that a child still do the test on a sample of urine has orthostatic proteinuria, two urine collected at any time during the day samples are collected and checked. (called a spot random sample). The first is collected in the morning, right after the child gets up (first If this test result is positive, then your void). The second sample is collected doctor will repeat the test two times throughout the day. If it is orthostatic within the next three months to see proteinuria, the first void sample won’t if you have persistent albuminuria. have any protein but the daytime A urine ACR test should be done at sample will have protein. least once a year if you have diabetes or high blood pressure, and every two How is albuminuria treated? Your doctor will monitor the level of of kidney disease cannot be cured diabetes and/or blood pressure. albumin in the urine to find out if it is but progression can be slowed by Your doctor may prescribe ACE increasing or decreasing. Further tests appropriate treatment. inhibitors or angiotensin receptor may be needed to investigate the blockers. These drugs have been In recent years the use of medications cause and extent of kidney damage. In found to protect kidney function such as ACE inhibitors or angiotensin some cases a kidney biopsy is the only while controlling blood pressure. receptor blockers has proved to be way to accurately diagnose the cause effective treatment for reducing If your child has orthostatic of albuminuria. This is done by passing albuminuria. Reducing the amount proteinuria, usually no treatment a needle through your skin into the of albuminuria means an improved is needed. The doctor will test your kidney, and a small piece of kidney outcome whatever the underlying child’s urine after a few months to tissue is removed for examination cause. This treatment has become check for the amount of protein. If the under a microscope by a pathologist. the standard approach in most cases. proteinuria hasn’t changed or if there If the biopsy finds a treatable cause is more protein, your doctor may send If your albuminuria is due to diabetes then the treatment may stop the your child to a kidney specialist. or high blood pressure, the first goal albuminuria. However most types will be better self-management of Connect with us www.kidney.org.au Freecall 1800 454 363 Kidney Health Australia Albuminuria Last Reviewed July 2015 Prevent, Detect, Support. Page 3 How can albuminuria be prevented? People at risk of developing CKD need You are at increased risk of CKD if you: • are obese (Body mass index ≥ 30) to have regular check-ups with their • have high blood pressure • are a smoker doctor to detect and treat kidney disease before it worsens. • have diabetes • are 60 years or older • have established heart problems • are of Aboriginal or Torres Strait (heart failure or past heart attack) Islander origin and/or had a stroke • have had an episode of acute kidney • have a family history of kidney failure injury This is intended as a general For more information introduction to this topic and is not about kidney or urinary meant to substitute for your doctor’s If you have a hearing or Health Professional’s advice. or speech impairment, All care is taken to ensure that health, please contact the information is relevant to contact the National the reader and applicable to Relay Service on our free call Kidney Health each state in Australia. It should be noted that Kidney Health 1800 555 677 or Information Service Australia recognises that each relayservice.com.au person’s experience is individual (KHIS) on 1800 454 363. and that variations do occur in For all types of services treatment and management due to ask for 1800 454 363 Or visit our website personal circumstances, the health professional and the state one kidney.org.au to access lives in. Should you require further information always consult your free health literature. doctor or health professional. Kidney Health Australia gratefully acknowledges the valuable contribution of the Royal College of Pathologists of Australasia for the review of this material. Connect with us www.kidney.org.au Freecall 1800 454 363.
Recommended publications
  • Understanding Your A1C Test
    Diabetes Advisor Understanding Your A1C Test What is the A1C test? The A1C is a blood test that tells you what your average blood sugar (blood glucose) levels have been for the past two to three months. It measures how much sugar is attached to your red blood cells. If your blood sugar is frequently high, more will be attached to your blood cells. Because you are always making new red blood cells to replace old ones, your A1C changes over time as your blood sugar levels change. “Because you are always making new What is eAG? red blood cells to eAG stands for estimated average glucose and is your estimated average blood replace old ones, sugar. This number translates an A1C test result into a number like the one you see when you test your blood sugar at home. For example, an A1C of 7% means your A1C changes that your average sugar for the last two to three months was about 154 mg/dL. over time as your What does an A1C/eAG result mean? blood sugar levels change.” Usually, your A1C gives you general trend in your blood sugar that matches what you see with your day-to-day blood sugar checks. Sometimes, however, your A1C result may seem higher or lower than you expected. That may be because you aren’t checking your blood sugar at times when it’s very high or very low. Use the chart below to understand how your A1C result translates to eAG. First find your A1C number on the left.
    [Show full text]
  • Serological (Antibody) Testing for Covid-19
    SEROLOGICAL (ANTIBODY) TESTING FOR COVID-19 Serological tests detect antibodies in the blood People in the early stages of COVID-19 might generated as part of the immune response test antibody negative despite being highly to a specific infection, such as infection with infectious. Additionally, some tests might give a SARS-CoV-2, the virus that causes COVID-19. false positive result because of past or present Antibody tests are different from tests such as infection with other types of coronaviruses. polymerase chain reaction (PCR) and antigen False positive results are also more likely tests which detect the SARS-CoV-2 virus. when the percentage of the population with Many new serological tests for COVID-19 have the disease is low. The Idaho Division of Public been developed and have an emergency use Health discourages persons who have a positive authorization (EUA) from the U.S. Food and serology test from relaxing the precautions such Drug Administration (FDA). Only antibody tests as social distancing that are recommended for that have an FDA EUA should be used. The all Idahoans to prevent spread of coronavirus, Idaho Division of Public Health discourages and strongly discourages employers form the use of unauthorized serology-based assays relaxing the employee protections for an for diagnosis of COVID-19 or determining if employee solely based upon a positive serology someone is currently infected or had a prior test. infection. The immune response to SARS-CoV-2 (the Serological tests are not recommended for virus that causes COVID-19) infection is not COVID-19 diagnosis in most situations because well understood.
    [Show full text]
  • Jaundice Protocol
    fighting childhood liver disease Jaundice Protocol Early identification and referral of liver disease in infants fighting childhood liver disease 36 Great Charles Street Birmingham B3 3JY Telephone: 0121 212 3839 yellowalert.org childliverdisease.org [email protected] Registered charity number 1067331 (England & Wales); SC044387 (Scotland) The following organisations endorse the Yellow Alert Campaign and are listed in alphabetical order. 23957 CLDF Jaundice Protocol.indd 1 03/08/2015 18:25:24 23957 3 August 2015 6:25 PM Proof 1 1 INTRODUCTION This protocol forms part of Children’s Liver Disease Foundation’s (CLDF) Yellow Alert Campaign and is written to provide general guidelines on the early identification of liver disease in infants and their referral, where appropriate. Materials available in CLDF’s Yellow Alert Campaign CLDF provides the following materials as part of this campaign: • Yellow Alert Jaundice Protocol for community healthcare professionals • Yellow Alert stool colour book mark for quick and easy reference • Parents’ leaflet entitled “Jaundice in the new born baby”. CLDF can provide multiple copies to accompany an antenatal programme or for display in clinics • Yellow Alert poster highlighting the Yellow Alert message and also showing the stool chart 2 GENERAL AWARENESS AND TRAINING The National Institute of Health and Clinical Excellence (NICE) has published a clinical guideline on neonatal jaundice which provides guidance on the recognition, assessment and treatment of neonatal jaundice in babies from birth to 28 days. Neonatal Jaundice Clinical Guideline guidance.nice.org.uk cg98 For more information go to nice.org.uk/cg98 • Jaundice Community healthcare professionals should be aware that there are many causes for jaundice in infants and know how to tell them apart: • Physiological jaundice • Breast milk jaundice • Jaundice caused by liver disease • Jaundice from other causes, e.g.
    [Show full text]
  • Surgeons, Columbia University, New York City) (Received for Publication August 9, 1932)
    THE ADDIS SEDIMENT COUNT IN NORMAL CHILDREN By JOHN D. LYTTLE (From the Babies Hospit and the Department of Pediatrics, Colege of Physicians and Surgeons, Columbia University, New York City) (Received for publication August 9, 1932) THE METHOD In 1925 Addis (1) described a method by which, in a concentrated acid urine, the rate of excretion of protein, casts and red and white cells could be determined. His method, with certain modifications, has been followed here. All of the counts were made on the 12 hour night specimen from 7 or 8 P.M. to 7 or 8 A.M. Addis recommended that fluids be restricted during, and for 12 hours preceding the collection, since in dilute and alkaline urine hyaline casts dissolve and red cells may be completely lysed. With children this rigid restriction of fluid proved impossible. Withholding fluid during the afternoon and night except for 200 cc. at the evening meal, gave urines of such concentration and acidity that they were suitable for a count. Most children had an early supper and col- lections were started at 7 or 8 P.M. Under these conditions, the urinary pH was between 5.0 and 6.0 and the specific gravity usually well above 1.020. The specimens were treated as described by Addis: "the con- centrated night urine is thoroughly mixed by repeated inversion of the rubber-stoppered bottle and a 10 cc. sample is transferred to a special graduated tube, and centrifugalized for five minutes at 1,800 revolutions per minute. The supernatant urine is decanted and pipetted down to a known volume which varies with the amount of sediment as judged by direct observation.
    [Show full text]
  • Lactose Tolerance Blood Test
    Lactose tolerance blood test Lactose tolerance tests measure the ability of your intestines to break down lactose, a type of sugar found in milk and other dairy products. How the test is performed The lactose tolerance blood test looks for glucose in your blood. Your body creates glucose when lactose breaks down. For this test, several blood samples will be taken before and after you drink the lactose solution described above. For information on how a blood sample is obtained, see venipuncture. How to prepare for the test You should not eat for 8 hours before the test. Avoid strenuous exercise for 8 hours before the test. How the test will feel There should not be any pain or discomfort when giving a breath sample. When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing. Why the test is performed Your doctor may order these tests if you have signs of lactose intolerance. Normal Values The breath test is considered normal if the increase in hydrogen is less than 12 parts per million over your fasting (pre-test) level. The blood test is considered normal if your glucose level rises more than 30 mg/dL within 2 hours of drinking the lactose solution. A rise of 20-30 mg/dL is inconclusive. Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results. The examples above show the common measurements for results for these tests.
    [Show full text]
  • Rotational Thromboelastometry Predicts Care Level in Covid-19
    medRxiv preprint doi: https://doi.org/10.1101/2020.06.11.20128710; this version posted June 12, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Rotational Thromboelastometry predicts care level in Covid-19 1 2 3 4 Lou M. Almskog, MD ;​ Agneta Wikman, MD, PhD ;​ Jonas Svensson, MD ;​ ​ ​ ​ 1 5 6 2 Michael Wanecek, MD, PhD ;​ Matteo Bottai, PhD ;​ Jan van der Linden, MD, PhD ​ ​ ​ 7 8 9 ;​ Anna Ågren, MD, PhD .​ ​ 1 Department​ of Anaesthesiology and Intensive Care, Capio St Göran’s Hospital, Stockholm, Sweden 2 ​ Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden 3 ​ Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital and Department of CLINTEC, Karolinska Institutet, Stockholm, Sweden 4 ​ Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden 5 Department​ of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden 6 Unit​ of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden 7 Perioperative​ Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden 8 Coagulation​ Unit, Division of Hematology, Karolinska University Hospital, Stockholm, Sweden 9 ​ Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2020.06.11.20128710; this version posted June 12, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
    [Show full text]
  • Understanding Your Blood Test Lab Results
    Understanding Your Blood Test Lab Results A comprehensive "Health Panel" has been designed specifically to screen for general abnormalities in the blood. This panel includes: General Chemistry Screen or (SMAC), Complete Blood Count or (CBC), and Lipid examination. A 12 hour fast from all food and drink (water is allowed) is required to facilitate accurate results for some of the tests in this panel. Below, is a breakdown of all the components and a brief explanation of each test. Abnormal results do not necessarily indicate the presence of disease. However, it is very important that these results are interpreted by your doctor so that he/she can accurately interpret the findings in conjunction with your medical history and order any follow-up testing if needed. The Bernards Township Health Department and the testing laboratory cannot interpret these results for you. You must speak to your doctor! 262 South Finley Avenue Basking Ridge, NJ 07920 www.bernardshealth.org Phone: 908-204-2520 Fax: 908-204-3075 1 Chemistry Screen Components Albumin: A major protein of the blood, albumin plays an important role in maintaining the osmotic pressure spleen or water in the blood vessels. It is made in the liver and is an indicator of liver disease and nutritional status. A/G Ratio: A calculated ratio of the levels of Albumin and Globulin, 2 serum proteins. Low A/G ratios can be associated with certain liver diseases, kidney disease, myeloma and other disorders. ALT: Also know as SGPT, ALT is an enzyme produced by the liver and is useful in detecting liver disorders.
    [Show full text]
  • Lab Dept: Urine/Stool Test Name: MICROALBUMIN, URINE
    Lab Dept: Urine/Stool Test Name: MICROALBUMIN, URINE General Information Lab Order Codes: UMAR Synonyms: Albumin/Creatinine Ratio CPT Codes: 82043 – Albumin: urine, microalbumin, quantitative 82570 – Creatinine; other source Test Includes: Urine Microalbumin in mg/L, Urine Creatinine in mg/dL and Albumin/creatinine ratio in mg albumin/g creatinine Logistics Test Indications: Increased excretion of albumin (microalbuminuria) is a predictor of future development of clinical renal disease in patients with hypertension or diabetes mellitus. Lab Testing Sections: Chemistry Phone Numbers: MIN Lab: 612-813-6280 STP Lab: 651-220-6550 Test Availability: Daily, 24 hours Turnaround Time: 1 day Special Instructions: N/A Specimen Specimen Type: Urine, random collection Container: Plastic leakproof container (No preservatives) Draw Volume: 1 - 3 mL from a random urine collection Processed Volume: Minimum: 1 mL urine Collection: A random urine sample may be obtained by voiding into a urine cup and is often performed at the laboratory. Bring the refrigerated container to the lab. Make sure all specimens submitted to the laboratory are properly labeled with the patient’s name, medical record number and date of birth. Special Processing: Lab Staff: Centrifuge specimen before analysis. Patient Preparation: Sample should not be collected after exertion, in the presence of a urinary tract infection, during acute illness, immediately after surgery, or after acute fluid load. Sample Rejection: Mislabled or unlabeled specimens; samples contaminated with blood Interpretive Reference Range: Albumin/creatinine ratio (A/C <30 mg/g Normal ratio) 30 - 299 mg/g Microalbuminuria >300 mg/g Clinical albuminuria Urine Creatinine: No reference ranges established Critical Values: N/A Limitations: Due to variability in urinary albumin excretion, at least two of three test results measured within a 6-month period should show elevated levels before a patient is designated as having microalbuminuria.
    [Show full text]
  • Albuminuria Versus Egfr
    Albuminuria versus GFR as markers of diabetic CKD progression KDIGO Controversies Conference: “Diabetic Kidney Disease” New Delhi, March 2012 Richard J MacIsaac PhD FRACP Director of Endocrinology & Diabetes, St Vincent's Hospital Professorial Fellow, University of Melbourne Evolution of Diabetic CKD Incipient Overt Nephropathy Nephropathy GFR 100 Log AER (ml/min) GFR 10 15 20 yrs Normoalbuminuria Microalbuminuria Macroalbuminuria (AER < 20 µµµg/min) (AER 20-200 µµµg/min) (AER > 200 µµµg/min) Stages of CKD Stage eGFR Description Predominant (ml/min/1.73 m2) AER status 1 > 90 Kidney damage with normal/high GFR Normo- Micro- 2 60-89 Kidney damage with mild reduction in GFR Micro- 3 30-59 Kidney damage with moderate reduction in Micro/Macro- GFR 4 15-29 Kidney damage with severe reduction in Macro- GFR 5 < 15 Kidney failure Albuminuria versus GFR as markers of diabetic CKD progression 1. Albuminuria as a predictor of diabetic CKD 2. GFR as a predictor of diabetic CKD 3. Albuminuria & GFR uncoupling/coupling 4. Summary Albuminuria as a marker of diabetic CKD progression • High Variability M N • Low Specificity • Spontaneous Regression µ • Δ AER ≠ Δ GFR Higher levels of urinary albumin excretion within the normal range predict faster decline in glomerular filtration rate in diabetic patients Babazono T et al. Diabetes Care 2009;32:1518-1520 Albuminuria versus GFR as markers of diabetic CKD progression 1. Albuminuria as a predictor of diabetic CKD 2. GFR as a predictor of diabetic CKD 3. ALbuminuria & GFR uncoupling/coupling 4. Summary GFR as
    [Show full text]
  • Community Lab Costs
    Sickle Cell This tests for the genetic trait which may lead to sickle cell anemia. Osteoporosis Screening This uses ultrasound to screen people for low bone density or osteoporosis and is completed by painlessly scanning the heel. Because osteoporosis rarely causes signs or symptoms until it’s advanced, the National Osteoporosis Foundation recommends a bone density test if you are: • A woman older than age 65 or a man older than age 70 • A postmenopausal woman with at least one risk factor for osteoporosis Community Lab Costs • A man between age 50 and 70 who has at least one osteoporosis (greatly reduced rates) risk factor • Older than age 50 with a history of a broken bone • Taking medications, such as prednisone, aromatase inhibitors or Wellness Panel........................................................................ $20 Fasting anti-seizure drugs, that are associated with osteoporosis Includes screening for glucose, electrolytes, kidney, liver and • A postmenopausal woman who has recently stopped taking thyroid, plus complete blood count and lipid profile hormone therapy • A woman who experienced early menopause Diabetic Screening (A1c)...................................................... $5 The results of this test will indicate if you have or at risk for osteoporosis. Sickle Cell................................................................................ $6 If so, your doctor can offer treatment. PSA (Prostate Screening)...................................................... $8 Breathing Test This measures airflow and lung
    [Show full text]
  • Prevalence of Microalbuminuria and Associated Risk Factors Among Adult Korean Hypertensive Patients in a Primary Care Setting
    Hypertension Research (2013) 36, 807–823 & 2013 The Japanese Society of Hypertension All rights reserved 0916-9636/13 www.nature.com/hr ORIGINAL ARTICLE Prevalence of microalbuminuria and associated risk factors among adult Korean hypertensive patients in a primary care setting Yon Su Kim 1, Han Soo Kim2, Ha Young Oh3, Moon-Kyu Lee4, Cheol Ho Kim5, Yong Soo Kim6,DavidWu6, Amy O Johnson-Levonas6 and Byung-Hee Oh7 Microalbuminuria is an early sign of nephropathy and an independent predictor of end-stage renal disease. The purpose of this study was to assess microalbuminuria prevalence and its contributing factors in Korean hypertensive patients. This cross-sectional study enrolled male and female patients of X35 years old with an essential hypertension diagnosis as made by 841 physicians in primary care clinics and 17 in general hospitals in the Republic of Korea between November 2008 and July 2009. To assess microalbuminuria prevalence, urine albumin/creatinine ratio (UACR) was measured in patients with a positive dipstick test. Of the 40 473 enrolled patients, 5713 (14.1%) had a positive dipstick test. Of 5393 patients with a positive dipstick test and valid UACR values, 2657 (6.6%) had significantly elevated UACR (X30 lgmgÀ1), 2158 (5.4%) had microalbuminuria (30 lgmgÀ1pUACR o300 lgmgÀ1) and 499 (1.2%) had macroalbuminuria (UACR X300 lgmgÀ1). Based on multivariate analysis, independent factors associated with elevated UACR included low adherence to antihypertensive medication (23% higher; P ¼ 0.042), poorly controlled blood pressure (BP; 38% higher for systolic BP/diastolic BP X130 mm Hg/X80 mm Hg; Po0.001), obesity (47% higher for body mass index (BMI) X25.0 kg m À2; Po0.001), age (17% lower and 58% higher for age categories 35–44 years (P ¼ 0.043) and 475 years (Po0.001), respectively) and a prior history of diabetes (151% higher; Po0.001) and kidney-related disease (71% higher; Po0.001).
    [Show full text]
  • Proteinuria and Albuminuria: What’S the Difference? Cynthia A
    EXPERTQ&A Proteinuria and Albuminuria: What’s the Difference? Cynthia A. Smith, DNP, CNN-NP, FNP-BC, APRN, FNKF What exactly is the difference between TABLE Q the protein-to-creatinine ratio and the Persistent Albuminuria Categories microalbumin in the lab report? How do they compare? Category Description UACR For the non-nephrology provider, the options for A1 Normal to mildly < 30 mg/g evaluating urine protein or albumin can seem con- increased (< 3 mg/mmol) fusing. The first thing to understand is the impor- tance of assessing for proteinuria, an established A2 Moderately 30-300 mg/g marker for chronic kidney disease (CKD). Higher increased (3-30 mg/mmol) protein levels are associated with more rapid pro- A3 Severely > 300 mg/g gression of CKD to end-stage renal disease and in- increased (> 30 mg/mmol) creased risk for cardiovascular events and mortality in both the nondiabetic and diabetic populations. Abbreviation: UACR, urine albumin-to-creatinine ratio. Monitoring proteinuria levels can also aid in evaluat- Source: KDIGO. Kidney Int. 2012.1 ing response to treatment.1 Proteinuria and albuminuria are not the same low-up testing. While the UACR is typically reported thing. Proteinuria indicates an elevated presence as mg/g, it can also be reported in mg/mmol.1 Other of protein in the urine (normal excretion should be options include the spot urine protein-to-creatinine < 150 mg/d), while albuminuria is defined as an “ab- ratio (UPCR) and a manual reading of a reagent strip normal loss of albumin in the urine.”1 Albumin is a (urine dipstick test) for total protein.
    [Show full text]