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Kidney Diseases

Microalbumin Results in Diabetic

04/06/2010

Question:

What is the difference of microalbumin/crea ratio result of the early morning urine sample to a late night urine sample?

Early morning urine sample for miroalbumin was in a range of 1,00 - 1500 ng/L;another sample was sent at about almost midnight of the same day and the result was almost half of the first result; 582 mg,L. Is it normal for a diabetic patient? What could be the possible reason of the big difference in result?

Answer:

The difference in the microalbumin (alone) level is the amount of water in the urine (the diluteness of the urine).  Early in the morning, urine will usually be the most concentrated that it will be in a 24-hr period, so the microalbumin level will be highest.  After drinking fluids all day and evening, most people will have more water in their urine, so the microalbumin level will be lower.  To correct for the amount of water in the urine, the ratio (microalbumin-to-creatinine) is used; that's the figure you should be looking at, and it should be relatively constant, regardless of the time of day.  A microalbumin-to-creatinine ratio of greater than 30 is considered to be elevated, and to represent some damage to the kidney.

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Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University