Microalbuminuria In Diabetic Kidney Disease

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Microalbuminuria In Diabetic Kidney Disease

What is diabetic kidney disease?
Kidney disease is one of the most serious complications of diabetes. After years of diabetes, the filtering units of the kidney (glomeruli) get scarred so that they cannot filter the blood efficiently. Eventually, the kidneys may fail completely so that the patient needs dialysis or a kidney transplant.

What causes diabetic kidney disease?
We don't know for sure. Part of the problem is probably genetic (inherited). However, high blood glucose levels and high blood pressure also contribute.

If I have diabetes, how do I know if I am likely to get kidney disease?
You cannot know for sure. However, certain things can make it more likely. These include: having a family member with diabetic kidney disease; high blood glucose levels: high blood pressure; and cigarette smoking.

Are there tests that can tell if my kidneys have been hurt by diabetes?
Yes; blood and urine tests can show if your kidneys are affected.

Are people who have Type I diabetes more likely to have kidney problems?
No; the risk of kidney problems is about equal in people with Type I and Type II diabetes. However, the risk of serious kidney failure (requiring dialysis or a kidney transplant) is higher in patients with Type I diabetes.

Are people who have diabetes and high blood pressure more likely to have kidney problems?
Yes. High blood pressure can make diabetic kidney disease worse, and it can also cause kidney problems on its own.

What does microalbuminuria mean?
Microalbuminuria means that the kidney has some damage, and is starting to spill some albumin (a kind of protein) in the urine. Microalbuminuria is the first sign of diabetic kidney disease.

How is microalbuminuria measured?
It can be measured by a specific urine test, either on a single urine specimen, or on a 24-hour urine collection. Any doctor can test for microalbuminuria. Routine urine analysis does not detect microalbuminuria.

Who should have this test? How often?
Everyone with diabetes who is between 12 and 70 years of age should have a urine test for microalbuminuria at least once a year. If positive, this should be reconfirmed on a second urine specimen.

Is it possible to have microalbuminuria without having any symptoms?
Yes; microalbuminuria itself does not cause any symptoms.

Are there signs that show an increased risk of microalbuminuria?
Not really, though certain risk factors (high blood glucose, high blood pressure) may be a clue that microalbuminuria is likely.

What would be considered a positive result?
For a 24-hour urine collection, 30 to 300 mg of albumin means microalbuminuria. In a single urine specimen, a level of more than 30 mg of albumin per gram of creatinine is considered positive.

Can other things (besides kidney disease) cause this test to be positive?
Yes. Some other conditions, such as essential hypertension, can also cause albuminuria. If the test is done during periods of illness, heavy exercise, urinary tract infections or poor blood glucose control, it may show a positive result.

Is there a home test that measure microalbuminuria?
No, there are no accurate home tests.

Is the test expensive? Does health insurance cover it?
The test is relatively inexpensive, and most health insurance plans will cover it. If you are not sure, check with your doctor or your insurance company.

Should people with both Type I and Type II diabetes be tested for microalbuminuria?
Yes. All people with diabetes are at risk for developing microalbuminuria.

Will tight control of glucose help?
Yes. Tight control lowers the risk of all diabetic complications, including the development of microalbuminuria and diabetic kidney disease.

Are there other things I can do to prevent kidney disease?
Keeping your blood pressure under good control and quitting cigarette smoking will both help to prevent diabetic kidney disease.

What dietary changes should I make?
You should stay on a diabetic diet, as prescribed by your doctor. If you have not seen a dietitian, ask to see one to help you learn all the possible ways you can control your diet.

Does a positive test for microalbuminuria suggest other problems besides kidney disease?
Microalbuminuria suggests a higher risk for heart disease, as well as kidney disease.

How many people who test positive for microalbuminuria develop kidney failure? How long does this take to occur?
Most patients with Type I diabetes who test positive for microalbuminuria will develop kidney failure after a number of years. For Type II diabetes, the number of people who will develop kidney failure is not known, but some of these patients will eventually get kidney failure.

If my kidneys fail eventually, what treatments are available?
Either dialysis or kidney transplantation can be used to treat kidney failure. Your doctor can provide you with more information about these treatments.

What is the National Kidney Foundation and how does it help?
More than 20 million Americans have some form of kidney or urologic disease. Millions more are at risk. The National Kidney Foundation, Inc., a major voluntary health organization, is working to find the answers through prevention, treatment and cure. Through its 52 Affiliates nationwide, the Foundation conducts programs in research, professional education, patient and community services, public education and Organ and Tissue Donation. The work of the National Kidney Foundation is funded entirely by public donations.

© 2009 National Kidney Foundation, Inc.