Johns Hopkins Health Alert
Microalbuminuria: What It Means
There are many causes of kidney disease, but having diabetes is a common one. Both elevated blood glucose and high blood pressure (another frequent problem among those with diabetes) damage blood vessels in the kidneys, just as they harm blood vessels throughout the body. In fact, a vicious cycle may develop. As your kidneys weaken, blood pressure often rises, and that in itself damages the kidneys further.
Diabetic nephropathy or kidney disease develops slowly over the course of years. And long before any physical manifestations are present, kidney disease leaves a clue that allows doctors to detect it early: microalbuminuria, or small quantities of the protein albumin in the urine.
When elevated blood glucose and blood pressure damage blood vessels in the kidneys' filters, protein starts to leak into the urine. At first, the leaks are tiny, so only small amounts of proteins like albumin slip through. At a later stage, the amount of protein in the urine, or proteinuria, increases.
You should be screened each year for microalbuminuria if you have type 2 diabetes or have had type 1 diabetes for at least five years (microalbuminuria is rarely present at the time of diagnosis of type 1). Screening is done with a simple "spot" urine test, meaning that it can be done any time of day with just one sample of urine. The lab measures the ratio of albumin to creatinine. Normal results are usually less than 20 or 30 mg albumin per gram of creatinine (less than 20 or 30 mg/g), depending on the lab.
One positive test (over 30 mg/g) should be confirmed, because simple things like a urinary tract infection, menstruation, or even exercise can give a positive result. If confirmed, though, microalbuminuria should be taken seriously.
What about blood tests? The fact is that no abnormalities show up in the blood until kidney disease has progressed beyond microalbuminuria. Once you do have a positive early urine test, though, you should have blood levels of serum creatinine measured at least once a year. Creatinine is a waste product and its blood levels indicate how well your glomeruli (network of tiny blood vessels) are filtering blood. The higher the blood creatinine level, the lower the glomerular filtration rate (GFR) and the more severe the kidney disease. A GFR of 60 to 89 mL/min indicates mild kidney disease or simple aging; 30 to 59 mL/min, moderate disease; 15 to 29 mL/min, severe disease; and less than 15 mL/min is a sign of kidney failure.
Posted in Diabetes on July 1, 2010
Reviewed January 2011
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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To whom it may concern: About ten years ago I had a serious bout of the flue, felt extremely tired, didn't sleep well and could barely walk up stairs. Yet I kept on working finely a day arrived where by turns I felt feverish and had the chills. I went to bed and stayed in bed for two days and wasn't improving except that my fever subsided but I would shortly sweat out any water I drank while my urine if I had the urge to urinate was only a dribble. When I saw my doctor he said that urinating small quantities sometimes happens with the flue then he told me to stay home for three days and keep on drinking plenty of fluids. A day after the visit I had no desire to drink and only drank barely a mouthful of juice or water once in a while as both water and juice tasted horrible I realized many years after that I had one of the symptoms of hydrophobia. That night I was tossing and turning in my bed when all of a sudden I felt that I was floating up in the air looking at myself in bed. I thought that I was dying and was resigned to it but then I was curious and asked myself why was this happening. Reviewing my existence in past few days I said basically I have been immobile in bed and only made occasional trips to the bathroom to try urinating and to the kitchen to drink plenty of fruit juices mostly from grapes and sometimes only water. It downed on me that the fruit juices provided plenty of Potassium but very little Natrium (that is salt.) A Scientific American article about six years before that day I recalled how a doctor coming back from having volunteered in Bangladesh I believe on his way back had stop in Rome for the airplane to be checked. The next day he was found dead in his hotel room with an opened prescription bottle of anti diarrhea pills apparently he suffered that now and then. The article mentioned that NGOs in the tropics where there are few medicines for kids had excellent outcomes by giving sick babies with diarrhea a glass of water with a teaspoon of salt and a table spoon of sugar. This gave me great hope enough to have the strength to get up and walk to the kitchen to drink this cocktail. The moment I drank in one instant my mouth felt totally different not normal by any means it wasn't till many more trips every hour or two to the kitchen till noon next day that I felt far better. I was now drinking soup or water and urinating like I hadn't done for quiet a while. When I went back to my doctor a few days after and told him about this he did not comment on my cure. But spent a good half hour talking about flue and assured me that I would not be getting it for at least five years then he gave me note for my absence to my employer. It's now ten years ago and I have learned one and only one thing that when I feel the symptoms of flue tiredness and kind of feverish (not much in my case) go to bed and stay there till you can't stand staying there any longer. Sincerely,
melliw
Posted by: melliw | February 6, 2011 2:26 PM