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RE: [IP] Microalbumin/Creatinine



Hi Tom,

 > MICROALB QT         RESULT: 3.2        
 > FLAG:H     REFERENCE 0-1.9 MG/DL.
 > EXPECTED VALUES 0-1.9

 > What the heck does this mean? [... My
 > PCP] just kind of glossed over it, and
 > directed my attention to the MA/CR
 > ratio (22.5), and said I was fine.

Usually, the interesting number for microalbuminuria is how much
is produced overnight (because of fewer possibilities for skewing
the result, like exercise), or over an entire 24-hour period (so
as to compute the average albumin output per hour). The 30-150
mg/day number refers to the normal value for _daily_ albumin
excretion.

For a spot check, they do not know (a) how much urine your bladder
contained and (b) over how many hours that urine was produced and
(c) under which circumstances (like, on a treadmill?) So they give
a concentration, from which we can figure a ball-park estimate:

3.2 mg/dl is your lab result. Assuming you produce, oh, 2.5 litres
of urine per day (25 dl), your total output would be 80 mg/day --
*IF* this was a representative sample, which it was not. Just one
example, albuminuria is 25% to 40% higher during the day, and that
isn't even taking account of moving around, and so on.

That is why your PCP pointed you to the albumin-to-creatinine
ratio. You see, if you have microalbuminuria due to kidney damage,
then creatinine output will be normal, albumin will be elevated,
so the ratio will be higher than normal. But if you are active or
feverish or have an allergy attack from ragweed or whatever, then
the kidney's spigot just opens w-i-i-i-de, and you pour out both
albumin and creatinine in increased quantities -- the ratio stays
normal (actually, it still increases, but not as much).

In your case, for every gram of creatinine in the urine, there
were 22.5 milligrams of albumin. "Normal" is between 0.0 and 30.0
mg/g, so as your PCP said, no worries about this test!

Cheers,
Felix.
.
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