Abstract
Microalbuminuria (40-200mgm/day) in Insulin Dependent Diabetes Mellitus (IDDM) predicts the development of irreversible diabetic nephropathy. We have developed a specific albumin radioimmunoassay with sensitivity (detection limit 2ng) and coefficient of variation, intraassay <6%, interassay <12%, to detect microalbuminuria. 24 hour urinary albumin excretion (UAE) in 120 normal children, age 3.5-15yrs; 49 males, 71 females, showed a positively skewed distribution and after log transformation, the Geometric Mean (GM) is 5.96mg/l (range: 1.8-38.5). In 97 children with IDDM, aged 2-19yrs; 40 males, 57 females, the GM of UAE after log transformation is 5.75mg/l (range: 1.15-31.2) being no different from the normal range. As it is desirable to have the ability to predict UAE from a single urine specimen, we examined the first urine specimen passed in the morning for albumin concentration (mg/1), (FMAC), and the ratio of Albumin (mg/1) to Creatinine (mmol/1), (Alb:Cr) in that specimen. The combined normal & IDDM data, n=212, showed a highly significant correlation (p < .001) between UAE & FMAC (r=.81) & UAE & Alb:Cr (r=.74). Using this data, a first morning Alb:Cr of <2.5 predicted normal UAE (<38.5mgm/day) in 203/204 individuals and Alb:Cr of >2.5 predicted microalbuminuria (40-121mgm/day) in 8/8 individuals. The data also suggests that FMAC gives equally good prediction of microalbuminuria.
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Cowell, C., Rogers, S., Vines, R. et al. 150 FIRST MORNING URINARY ALBUMIN: CREATININE PREDICTS MICROALBUMINURIA. Pediatr Res 19, 628 (1985). https://doi.org/10.1203/00006450-198506000-00170
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DOI: https://doi.org/10.1203/00006450-198506000-00170