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Published by Bupa's health information team, January 2010.
This factsheet is for people who have microalbuminuria, or who would like information about it.
Microalbuminuria is a condition where very small amounts of the protein albumin pass through your kidneys and into your urine. This can be a sign of underlying conditions such as kidney disease or cardiovascular disease.
Your blood contains cells and proteins that you need, as well as waste products that your body needs to get rid of. Your blood is filtered by your kidneys and waste products are removed from your body in your urine. Usually, cells and proteins stay in your blood, but sometimes a small amount of protein is lost into your urine along with other waste products.
Microalbuminuria is when the level of the protein albumin in your urine is always slightly raised. Microalbuminuria is defined as 30 to 300mg of albumin being lost in your urine per day. This is different to proteinuria, which is when the levels of protein in your urine are higher than 300mg a day.
Microalbuminuria means that the blood vessels involved in filtering waste products in your kidneys are damaged. Microalbuminuria may be the first sign of kidney damage or kidney disease. People with type 1 and type 2 diabetes may have kidney damage as a complication of their diabetes. If you have diabetes and microalbuminuria is detected early, there are treatments that can reduce the damage to your kidneys.
Microalbuminuria can also be a sign of more widespread damage to your blood vessels, including those of your heart. Microalbuminuria can be a sign that you're at an increased risk of heart disease, particularly if you have type 2 diabetes.
Causes of microalbuminuria
The development of microalbuminuria has been linked to diabetes. As well as diabetes, other risk factors for developing microalbuminuria include:
- high blood pressure
- a family history of diabetic kidney disease
- being overweight
Diagnosis of microalbuminuria
You will need to have specialised urine tests, which include the following.
Your GP will take a sample of your urine and send it to a laboratory for testing. If your GP thinks you have microalbuminurea, you will usually be asked to do this test two more times within three to four months, to confirm the diagnosis. You will be diagnosed as having microalbuminuria if your ACR is:
- 2.5mg/mmol or higher (for men)
- 3.5mg/mmol or higher (for women)
24-hour urine sample
You will be asked to collect all of your urine over a 24-hour period. The sample will be sent to a laboratory for testing. This gives an accurate measurement of how much albumin is lost in your urine during one day.
For this test, microalbuminuria is defined as having 30 to 300mg of albumin in your urine. However, the test results can be affected by:
recent exercise (within 24 hours before the test)
- a urinary tract infection
- heart failure
- uncontrolled blood sugar levels
- blood in your urine
Tell your GP or nurse if you have any of these problems. If you have exercised within a day of being due to start collecting your urine, the test can be re-arranged for another day.
If you have microalbuminuria, your GP will monitor your condition. You will usually be asked to have a urine test at least once a year and your GP will discuss the different types of treatment available, which include the following.
Diet and exercise play a key role in controlling your blood sugar levels and reducing your weight, blood pressure and cholesterol levels, in turn preventing any further kidney damage. Your GP will advise you how to live a healthy lifestyle. Steps may include:
exercising regularly, if possible for 30 minutes a day
- eating at least five portions of fruit and vegetables a day
- increasing the amount of starchy carbohydrates you eat
- choosing to eat carbohydrates that release energy slowly such as porridge oats, brown rice and pasta, lentils and beans and avoiding those that release energy quickly such as white bread and white rice
- reducing the amount of sugar, fat and salt in your diet
- stopping smoking
- cutting down on alcohol
- monitoring and controlling your blood sugar levels if you have diabetes
If you develop kidney disease, you may need to change your diet to help your kidneys to cope with waste products. You may need to limit the amount of certain foods you eat, such as those containing high levels of protein, sodium, potassium or phosphate. If you need to do this, your GP can refer you to a dietitian for advice.
Medicines called ACE inhibitors and angiotensin receptor blockers can be used to slow down kidney damage. These medicines can help to reduce your blood pressure as well.
Having microalbuminuria can be a sign of cardiovascular disease, so your GP may prescribe a cholesterol lowering medicine called a statin if you're over 40, or if you're younger and have other cardiovascular risk factors, such as high blood pressure. Your GP may also ask you to take 75mg of aspirin daily if you're particularly at risk of heart attack or stroke, especially if you've already had one or the other in the past.
See our answers to common questions about microalbuminuria, including:
- Kidneys (nephropathy). Diabetes UK. www.diabetes.org.uk, accessed 5 October 2009
- Managing renal problems. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 5 October 2009
- Type 2 diabetes. National clinical guideline for management in primary and secondary care (update) - The National Collaborating Centre for Chronic Condition, published by the Royal College of Physicians, May 2008. www.nice.org.uk
- Assessing the kidney. Clinical Knowledge Summaries. www.cks.nhs.uk, accessed 5 October 2009
- Microalbuminuria. GP Notebook. www.gpnotebook.co.uk , accessed 5 October 2009
- Belch J, MacCuish A, Campbell I et al. The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlledtrial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. BMJ 2008; 337:a1840. doi:10.1136/bmj.a1840
- Diet. Diabetes UK. www.diabetes.co.uk, accessed 5 October 2009
- Statins - British National Formulary. www.bnf.org , accessed 5 October 2009
- Angiotensin-converting enzyme inhibitors. British National Formulary. www.bnf.org, accessed 5 October 2009
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: January 2010.