Microalbumin - Please Help!

Type 1 and LADA
#1

I just got back my latest lab tests and saw that on the results of the urine test it said that my Microlabumin was at 10 mg/dl… Can anyone tell me what this means… I have been trying to get some information online but I cant really find anything good. From the looks of the lab tech, I got the idea that this was very high… and of course no good for me.

From what I have found, I have learned that this indicates a possible problem with kidney damage…

My A1c was high and I have been working hard to bring it down (now at 8.6)… but this, if it does indicate kidney damage, brings a whole new urgency to the table.

Complications
#2

You are spilling protein in your urine. It can indicate kidney damage, I had a scare with it one time and they did a 24 hour urine collection on me and it was a false positive. Don’t panic until you ask for a 24 hour urine to see if it was a false positive or not.

#3

A microalbumin test checks urine for the presence of a protein called albumin. Albumin is normally found in the blood and filtered by the kidneys. When the kidneys are working properly, albumin is not present in the urine. However, when the kidneys are damaged, small amounts of albumin leak into the urine. This condition is called microalbuminuria.

Microalbuminuria is most often caused by kidney damage from diabetes. However, many other conditions can lead to kidney damage, such as high blood pressure, heart failure, cirrhosis, or systemic lupus erythematosus (SLE). If early kidney damage is not treated, larger amounts of albumin and protein may leak into the urine. This condition is called macroalbuminuria or proteinuria. When the kidneys spill protein, it can mean serious kidney damage is present. This can lead to chronic kidney disease. A microalbumin urine test can be done on a sample of urine collected randomly (usually after the first time you urinate in the morning), a sample collected over a 24-hour period, or a sample collected over a specific period of time, such as 4 hours or overnight.

#4

what was your GFR? or Glomular Filtration Rate?

#5

hi Eduardo, there is urgency to get your blood sugar down - even without kidney troubles. It is most likely that your doctor will want to start you on a blood pressure medication (ACE inhibitor) to help protect your kidneys even if your bp is normal.

#6

Hi Joe,

My blood pressure could not be better… at the time my blood was drawn, it was at 117/78… my pulse was even better… 68 beats per min resting…

I have an appointment on the 3rd of Dec… i just want to make sure I understand what is happening to my body so that I can ask my endo the right questions…

Does this mean permanent kidney damage? Is this brought about because of my high sugar levels? Can this be reversed? Will this get worse? Please forgive my ignorance, but since my type 1 diagnosis almost 14 years ago nothing this serious has happened to me.

Thanks to all…

#7

Microalbuminuria
Microalbuminuria is defined as excretion of between 30 and 300mg of albumin a day in the urine.
• Less than 30 mg is insignificant.
• Over 300 mg is albuminuria or macroalbuminuria.
Albumin levels below 300mg a day are not detectable by standard dipstick testing, so any positive result is more severe than “microalbuminuria”.
Aetiology
Patients with type 2 Diabetes may have microalbuminuria at presentation as they may have had latent disease for years.
This is not usual in type 1 Diabetes. Hence it is recommended that annual screening for microalbuminuria should start at diagnosis in type 2 but only after 5 years in type 1.1

Risk Factors Diabetes and hypertension are both risk factors but together the risk is very high.
Other causes of albuminuria include:
• Glomerulonephritis.
• Amyloidosis.
• Other forms of nephropathy.
All pass through a brief phase of microalbuminuria, but this is short and the diagnosis is usually made with a more substantial proteinuria.
Making the Diagnosis
• An early morning urine specimen is more convenient than a 24 hours collection.
• The upper limit of normal is regarded as a urine albumin:creatinine ration of 2.5mg/mmol in men and 3.5mg/mmol in women.
• Some laboratories set a limit of 20mg albumin per litre.
• A positive result should be repeated once or twice in the next month and if it is borderline a full 24 hours urine collection will give a more definitive result.
• Levels below 300mg a day are not detectable by conventional dipstick testing but there are now some sticks for microalbuminuria available on the market.
• False positive results can occur after heavy exercise or with UTI.
• If a diabetic develops heavy proteinuria, especially in a fairly short space of time, then another cause should be sought.
• The same is true if there is no retinopathy.
• If blood creatinine rises above 150 μmol/l referral to a nephrologist is recommended.

#8

Hi Eduardo,
You have gotten some really good information. Make sure to follow what Landileigh said about asking about your GFR. If you have had other urinalyisis tests run go back over those and ask the doctor about what they said. If you are suddenly spilling the albumin I would definitley ask for an EKG because you would have a cardiovascular risk there. I would just sit down with the doctor and ask what all he has in mind for you and what your risk factors are That is far better than worrying about all of this before knowing what is real for you and what isn’t. Sometimes we spend time worrying over something when what we are doing is just adding more stress unnecessarily. Ther is plenty of time to worry about something when and if it comes up true For now until you actually find out from the doc I would relax and get my blood sugar under control. Being scared and worried will only raise your bllod sugar and blood pressure before you go in. So, relax, find your peaceful center and wait to find out what is real. My best to you.

#9

In addition to all the great information shared here, here are a few other resources you may want to look into:
http://en.wikipedia.org/wiki/Microalbuminuria
http://diabetes.webmd.com/microalbumin-urine-test
http://kidney.niddk.nih.gov/Spanish/pubs/kdd/index.htm (in Spanish)

Please let us know how your appointment goes.

#10

Manny and the rest of the wonderful people who answered my question,

Thank you all very much… As I mentioned before… this is the first time that such an important thing has happened in my nearly 14 years being a Type 1. I have been reading a great deal on the subject and that together with your comments, answers and recommendations have been a great help.

I guess that the most important part is to take things calmly and talk to my endo… my appointment is tomorrow BTW…

Manny, the WebMd and the niddk.nih.gov sites were the ones that helped the most. I was reading on the WebMd site that anything less than 30mg/day of albumin in urine can be considered as normal… that has taken a great deal of the pressure off… I still have to see this and talk about it with my Endo, but it is not considered to be as grave as I thought it to be.

Thanks to all and I will keep you updated.

#11

To Sue or not to Sue…??? That is the question running through my head this morning…

For all of you who replyed… THANKS!!! I went to my endo and he was very understanding… he told me that we should have further lab work done… the urine test that was done initially only had the microalbumin result but said nothing about the creatinine levels… so he gave me a prescription to take back to the lab for more tests…

I had more blood drawn (lipid panel) and more urine taken… Lab results were available today and I went to the lab… turns out that my very HIGH microalbumin results were a TYPOGRAPHICAL mistake by the individual who was inputing all of the information into the system!!! My microalbumin random result was really <0.1 mg/dl… and NOT the >10.0 mg/dl that was initially reported!!! The creatinine was at 26.3 ug/mg and the Microalbumin:Creatinine was at <0.04!!!

I am sooooooooo relieved… but the relief I feel is almost overun by how PISSED OFF I am at these idiots!!! I have spent the last 2 1/2 weeks scared… worried… concerned… and turns out that for nothing!!!

On one hand it gave me the opportunity to have a very frank discussion with my wife and myself about how life would change with possible kidney damage… but this is a discussion I would have liked to have under different circumstances…

My anger goes from suing the crap out of them (that is if this is possible)… to thanking them for making me look further inside for a more responsible way to manage my type 1…

Again I thank all of you how gave me your experiences and opinions.

#12

Thanks for updating us,thanks God your results are normal.For any microalbumine/creatinine abnormal result,we repeat the test on two another occasions,if blood pressure is normaland GFR is normal,if not we go for 24 hr urine for albumin.
Best wishes

#13

Hey there - not sure if anyone will reply to this - since it’s been awhile since anyone posted - but I need help. Went to endo today - A1C was 5.7% - last visit 6 months ago it 5.9%. I’ve been trying to eat less carbs due to a friend of mine swearing by it - for getting her to an A1C level of 5.1%. Well, today, my endo told me he found protein in my urine (I don’t know how much - sorry forgot to ask) - and has put me on Avapro 150 mg and asked to see me again in 6 months. I came back home and started researching - and high protein diets are not good for people who have kidney problems. I forgot to tell endo that I was eating this way. Do you think I should go back to my regular way of eating - aka ADA? The women who does the low-carb (she doesn’t eat fruit or much bread, rice, etc.) eating poo poos the ADA diet - but up until now - I never had protein showing up in my urine! Anyway, hope someone can jump in and make me feel less freaked out!!!

#14

Hi Eduardo,

Glad to hear that your numbers are good. Anything under 30 is good, according to my endo. I went through this same process about half a year ago. I was registering a 65 mg/dl of microalbumin. They put me on lisinopril and my numbers are down, much closer to normal.

As for suing and ticked off, use it to fuel you to continue to take good care of your BG’s and yourself. The fact that you don’t have kidney troubles is the big picture. You’ve gotten a scare/wakeup call, so use it as fuel.

Plus, I wouldn’t be surprised if lab people are being overworked and rushed, so they probably aren’t doing enough proofing/checking/quality control. So it goes…

And the next time your in for more labwork, give the technicians and your doc and nurse as much grief as they can bear.

“Hey, did you guys figure out where to put the decimal point this time?”

“Hey doc! Are you taking some sort of remedial handwriting class, b/c I have no idea what you just wrote on my prescription card. Is that a drawing of a bunny?!”

etc.

Cheers, Mike

#15

Anna, I am no doctor but are you also hypertensive? If your bp is high this drug will protect your kidneys and lower your bp. I If your kidkeys are passing protein then IMO it’s a problem of some kind. The “—sartan” salts are known to stop the spilling of proteins and protect your kidneys… if you can tolerate them. I take vasotec, to help my mild hypertenstion and to protect my kidneys (I was not passing proteins at the time) but it took a few weeks to get used to the drug.

you can also do low carb without super high protein intakes, too (you can follow or modify the south beach diet) - I don’t have much to add on this topic but there should be plenty of info out there, some of it might even be helpful :wink: take care and good luck

#16

Happy to hear you are A-okay. Sorry you had to worry for weeks. But your post did a lot of good in bringing forth a topic to educate others. I learned a lot from it. Glad you can relax now.