Microalbumin Test

A microalbumin test is advised by the healthcare professionals to identify early damage to the kidneys in patients who are at risk of developing microalbuminuria. Diabetic and hypertensive patients are usually at the risk of developing kidney damage. Hence, a regular check-up of urine microalbumin is suggested by doctors, which can detect minute amounts of albumin in urine.

The American Diabetes Association (ADA) provides detailed guidelines on the screening of patients with diabetes mellitus for the early diagnosis and management of complications. According to the ADA, patients with type 2 diabetes mellitus should be tested for microalbuminuria immediately at the time of initial diagnosis of diabetes, and annual check-ups are required thereafter. For patients with type 1 diabetes mellitus (insulin-dependent diabetes), tests for microalbuminuria should be performed five years after the initial diagnosis of diabetes followed by yearly check-ups.

As albuminuria is usually associated with diabetes, the signs and symptoms of diabetes are worth a mention. These include:

• Frequent urination
• Increased thirst
• Increased appetite
• Problems with healing after an injury
• Fatigue
• Blurred vision
• Weight loss      
• Numbness and tingling sensations in hands and feet

Besides diabetes and hypertension, this test is also advised for other conditions, including diseases of blood vessels, preeclampsia (raised blood pressure in pregnancy), impending kidney damage and suspected urinary tract infection.   

It is a simple urine test. The doctor may suggest a random urine sample, timed urine sample, or 24-hour urine sample. He/she would provide specific precautions or instructions regarding urine collection. This may include avoiding contamination of urine with materials, such as toilet papers or faeces. It is important to discuss with the doctor about any medications that you may be taking, as some of them, such as oxytetracyclines or other antibiotics, may interfere with test results. Also, this test can be performed with other urine tests, such as microalbumin to creatinine ratio, which may need further precautions. 

Microalbumin test or urine albumin test can be performed in different ways as mentioned above. You will be given a sterile container for collecting urine along with specific instructions based on the type of test. A random urine test is usually a one-time collection of urine in the laboratory. In a timed urine test, urine is collected for a specific predefined duration. For a 24-hour test, patients need to collect urine over a period of 24-hours;    bladder should be emptied completely in the morning, and this first sample is discarded. Thereafter, all urine samples are collected for the next 24-hours. The samples are then transported to a laboratory for examination.

Microalbumin levels in urine are usually measured in milligrams per day (mg/day). 

Normal results: Normal values of albumin in urine is less than 30 mg/24 hours (<30 mg/day) or less than 20 mg/L (10-hour collection) for an adult (laboratory normal ranges may vary slightly for different labs).

Abnormal results: Microalbuminuria, if detected in a urine test, is considered an abnormal finding. Increased levels of albumin are found in the following conditions:

• Diabetes (kidney damage or nephropathy in diabetes)
• Thickening of blood vessels or atherosclerosis
• Hypertension (kidney damage or nephropathy in hypertension)
• Nephropathy
• Medications causing kidney damage
• Pre-eclampsia (raised blood pressure during pregnancy)
• Urinary tract infection

Besides these conditions, microalbumin levels may get affected in people who take protein supplements or excess salt, do vigorous exercise or in women during menstruation. If microalbuminuria is detected, the doctor may advise further investigations for proper diagnosis and treatment of the underlying condition. 

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational perspective and is in no way a substitute for medical advice from a qualified doctor.