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Diabetes Update

Microalbuminuria
What it is. How to Deal With It

Microalbuminurea (micro-al-bewmin-ur-ee-ah) is the term given to a condition where small pieces of protein (albumin) are present in the urine. Albumin is produced by the liver and normally present in the bloodstream. It serves many purposes, including the maintenance of the osmotic pressure that ensures fluid remains within the blood stream instead of leaking out into the tissues.

Healthy kidneys act as a filtration mechanism that prevents albumin from being excreted. Therefore, any trace of albumin in the urine is a warning that the kidneys may not be functioning as well as they should.

A Cause for Concern

Although microalbuminuria may have other causes, it is most often a complication of diabetes. Many people with severe or uncontrolled diabetes develop microalbuminuria. While not in itself a disease, the condition serves as an early sign that health problems could be developing and need to be addressed. If detected at an early stage, kidney damage can be successfully treated and frequently reversed.

There are three risk factors for microalbuminuria:

having diabetes
elevated blood pressure
genetic predisposition

Microalbuminuria needs to be addressed immediately because it can lead to deterioration of kidney function and enlargement of the kidneys. (It is also considered a risk factor for heart disease.) The condition may lead to proteinuria, where larger proteins are excreted in the urine. This is a far more serious condition which can cause renal failure necessitating renal dialysis or organ transplant.

Since microalbuminuria may be indicative of kidney problems, it is important to be tested for the condition if you have diabetes.

The Importance of Testing

Detecting microalbuminuria is very important as, when caught early, the condition is treatable with medications. Doctors recommend that testing be carried out a minimum of once a year. The test normally involves the collection of urine over a 24-hour period.

Drugs routinely used to treat microalbuminuria include ARBs (angiotensin renin blockers) such as Avapro®, and ACE (angiotensin converting enzyme) inhibitors such as Altace® . Both these classes of drug are better known for their role in the management of high blood pressure. By controlling the pressure of blood within the kidneys, these drugs effectively reduce the excretion of blood albumin.

A Little Prevention

If you have diabetes, it is important that you undergo all the tests your doctor recommends. If you have not had a test for microalbuminuria, you might want to suggest this to your doctor. You can help prevent and/or manage the condition - and decrease your risk of associated cardiovascular disease - by observing the following:

Take all drugs prescribed for you
Be vigilant in controlling your blood sugar
Stop smoking
Keep active by exercising every day
Discuss taking a daily low dose aspirin with your doctor