Diagnosing Diabetic Nephropathy

Diagnosing Diabetic Nephropathy

Microalbuminuria is a condition in which the protein albumin is present in the urine. The urine contents are determined by the kidneys. If the kidneys aren’t working properly, they might leak things into the urine that are normally filtered back into the blood and used by the body. When the walls of the glomerulous are damaged, which happens in diabetic nephropathy, they lose their ability to filter the right way. Microalbuminuria is one of the hallmark diagnostic signs of diabetic nephropathy.

The best way to test for microalbuminurea is through a urine sample. However, low levels of albumin are often hard to register in a urine test, so sometimes several have to be done over a 24-hour period. Tests can be done as the first urine in the morning or at a medical visit. This method is accurate, easy to perform, and recommended by American Diabetes Association guidelines. The results of albumin measurements in spot collections may be expressed as urinary albumin concentration (mg/l). 30-300 mg/L are the ranges of urinary albumin excretion (UAE) that are categorized as microalbuminurea. 

Screening for microalbuminuria should be performed yearly, starting 5 years after diagnosis in type 1 diabetes or earlier in the presence of puberty or poor metabolic control. In patients with type 2 diabetes, screening should be performed at diagnosis and yearly thereafter. Around 7 % of Type 2 diabetics already have the disease when they are diagnosed with diabetes. 

Gross, Jorge, Mirela De Azavedo, and Sandra Silveiro. "Diabetic Nephropathy: Diagnosis, Prevention, and Treatment." Diabetes Care 28.1 (2005): 164-76. Web.