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Measurement of Albuminuria (Siemens
Healthcare)
The clinical significance and measuring method of albuminuria
Tsuneo Konta
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
In Japan, a number of dialysis patient keeps rising continuously, reaching more than 300,000 this year.
Although diabetic renal disease alone accounts for more than 40% of the total primary disease for
dialysis, the early detection and prompt therapy can suppress the progress of the disease.
The early stage of diabetic nephropathy does not cause any certain symptoms except moderate increase
of urinary albumin excretion (“microalbuminuria”). If untreated, it can progress into macroalbuminuria,
irreversibly damage the kidney and eventually lead into end-stage renal failure. Thus, the early detection
of nephropathy by monitoring urinary albumin excretion is essential to treat diabetic patients.
In recent years, microalbuminuria is known to exist in the majority of hypertensive patients, besides
diabetic patients. Furthermore, the presence of microalbuminuria is closely correlated with the incident
of cardiovascular diseases; and the decrease of urinary albumin excretion can abate these risks.
However, urinary albumin is not measured adequately, even for diabetes patients, because it takes time
to analyze and the frequency of its measurement is limited in Japan. Moreover, the urinary albumin
concentration can be affected by body position and fluid intake. To diagnose albuminuria correctly, it is
recommended to measure both albumin and creatinine levels in morning urine sample.
In June 2012, a new CKD treatment guide 2012 is launched by the Japanese Society of Nephrology,
recommending the use of urinary albumin/creatinine ratio for diabetic patients and urinary
protein/creatinine ratio for nondiabetic patients for CKD classification. In both cases, the correction by
urinary creatinine is essential to alleviate the urinary concentration.
At this seminar, the clinical data will be presented, including the association between urinary albumin,
kidney disease, and cardiovascular disease, and the importance of creatinine modification for the
accurate evaluation of urinary albumin excretion; based on Japanese patients.
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