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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. doi:10.1001/archinte.1991.00400090047009.
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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)


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