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Albumin in the urine
Last reviewed: 04.07.2025
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Microalbuminuria testing (urine albumin test) is used to screen for kidney disease, particularly diabetic nephropathy, which significantly reduces costs and improves the prognosis of end-stage renal failure.
The incidence of diabetic nephropathy is 40-50% in patients with type 1 diabetes mellitus and 15-30% in patients with type 2 diabetes mellitus. The danger of this complication is that it develops slowly and gradually, so it remains unnoticed for a long time. The earliest sign of diabetic nephropathy (before the appearance of proteinuria) is microalbuminuria. Microalbuminuria is the excretion of albumin in the urine, exceeding the permissible normal values, but not reaching the degree of proteinuria. Normally, no more than 30 mg of albumin is excreted per day, which is equivalent to an albumin concentration in the urine of less than 20 mg / l in a single analysis. With proteinuria, the excretion of albumin in the urine exceeds 300 mg / day. Thus, the range of fluctuations in the concentration of albumin in urine with microalbuminuria is from 30 to 300 mg/day or from 20 to 200 μg/min. The appearance of constant microalbuminuria in a patient with diabetes mellitus indicates the likely development (within the next 5-7 years) of a pronounced stage of diabetic nephropathy.
Another early marker of diabetic nephropathy is impaired intrarenal hemodynamics (hyperfiltration, renal hyperperfusion). Hyperfiltration is characterized by an increase in the glomerular filtration rate (GFR) above 140 ml/min. To determine the GFR, the Reberg-Tareev test is used, based on the study of endogenous creatinine clearance.
Classification of types of albuminuria
Albumin excretion in urine |
Concentration |
||
Type of albuminuria |
For single urine collection, mcg/min |
Per day, mg |
Albumin in urine, mg/l |
Normoalbuminuria Microalbuminuria Macroalbuminuria |
Less than 20 20-200 More than 200 |
Less than 30 30-300 More than 300 |
Less than 20 20-200 More than 200 |
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