ALBUMINURIA

•	Indicator of kidney damage and / or ...
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Description

ALBUMINURIA



•	Indicator of kidney damage and / or a biomarker of systemic diseases dates back to 1969, when elevated albumin levels were first demonstrated in the urine of patients with newly diagnosed diabetes.



•	Urine dipstick is a relatively insensitive marker for albuminuria, not becoming positive until albumin excretion exceeds 300-500 mg/day. 

•	Normal rate of albumin excretion is < 30 mg/day (20 mcg/min).

•	Persistent albumin excretion between 30-300 mg/day (20 to 200 mcg/min) is called moderately increased albuminuria (formerly called "microalbuminuria").

•	Excretion > 300 mg/day (200 mcg/min) represents overt or dipstick positive proteinuria (severely increased albuminuria [formerly called "macroalbuminuria"]



•	Albuminuria reflects functional and / or structural changes in the glomerular filtration membrane that allow increased leakage of albumin into primary urine in amounts exceeding the reabsorption capacity of the proximal nephron tubules. 

•	Albuminuria considered as an indicator of early damage (dysfunction) of the vascular endothelium (including the glomerular vessels), which leads to increased permeability of the vascular wall. 



•	Relationship between albuminuria and cardiovascular risk has been shown in studies of the general population. 

•	It is linear and risk is independent of eGFR. 

•	Associated with arterial stiffness assessed by the pulse wave velocity measurement. 



#Albuminuria #cardiovascular #eGFR #AER #ACR #macroalbuminuria #microalbuminuria
Contributed by

Satyendra Dhar, MD
@DharSaty
#Hospitalist
Hospital Medicine
Assistant Clinical Professor

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