How is it used?
Urine microalbumin is used to screen those at risk of developing Chronic Kidney Disease, even very small increases in albumin may indicate impaired kidney health. Diabetes is a very common cause of kidney failure. Studies have shown that identifying diabetics in the very early stages of kidney disease by demonstrating microalbuminuria helps patients and doctors adjust treatment. With better diabetic control and better control of other complications, such as high blood pressure, the progression of diabetic kidney disease can be slowed or prevented.
Microalbumin is also a marker for cardiovascular disease for type 2 diabetics..
When is it requested?
ACRU should be requested when a person is first diagnosed with diabetes to establish a baseline level. After that, screening is usually annual using the ACRU test. When significant levels of albumin have been found, the test may be done more frequently.
What does the test result mean?
Moderately increased ACRU levels in urine indicate that a person is in one of the very early phases of developing kidney disease. Recently, studies have shown that an abnormal ACRU result indicates an increased risk of developing heart and blood vessel (cardiovascular) complications, especially in people with diabetes. Low levels are an indication that kidney function is normal.
Moderate to high, persistently elevated levels of albumin in urine over three to six months is a requirement for establishing a diagnosis.
Other causes of elevation of albumin in urine which tend to be transient are fever, infection, exercise, high blood pressure and raised lipid levels.
Is there anything else I should know?
ACRU should be performed on the first specimen of urine passed after getting up in the morning. If this is not possible a random urine specimen is acceptable.
Note vigorous exercise is a common cause of transient elevation of urine albumin, and should not be performed for 24 hours prior to collecting the urine sample.
Similarly acute febrile illness and urinary infection may cause transient elevations so it is preferable sample be taken when patient is well.
There are dipsticks available for urine albumin measurement, but they may be subject to false positive or negative results depending on the urine volume for the sample tested.
Albumin to Creatinine Ratios Urine (ACRU) for moderate excretion range from 3.4 to 34 mg/mmol of Creatinine, and is associated with declining kidney function.
ACRU ratios higher than 34mg/mmol are indicative of markedly increased levels of albumin in urine and have a high predictive value of renal disease progression.