How to detect albuminuria

Kidney cartoon 3

 

How to detect albuminuria:

  • The preferred method for assessment of albuminuria in both diabetes and non diabetes is urinary ACR measurements in a first morning void spot speciment
  • Urinary protein excretion follows a circadian pattern and tends to be highest in the afternoon, so ACR tests are most accurate when performed on early morning (first void)
  • Where a first void specimen is not possible or practical, a random spot urine specimen for urine ACR is acceptable
  • A positive ACR test should be repeated on a first void sample to confirm persistence of albuminuria
  • Albuminuria is said to be present if at least two out of three ACR result are positive. Chronic kidney disease is present if the albuminuria is persistent for at least three months
  • Dipstick for protein in the urine is now no longer recommended as the sensitivity and specificity are not optimal
  • Urine ACR exhibits greater sensitivity than protein:creatinine ratio (PCR) for detecting lower amounts of clinically important albuminuria
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