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MICROALBUMINURIA – early warning sign for renal damage

Xtra article edition 2/2017

Microalbuminuria increasingly becoming the focus of attention.
Up to now, the diagnosis has been complicated and costly. New test strips from Sysmex make the process much cheaper and easier.

 

The World Health Organisation (WHO) and the international association “Kidney Disease – Improving Global Outcomes” (KDIGO) recommend two-parameter screening for chronic kidney disease (CKD) – based on serum creatinine and microalbuminuria. Professor Joris R. Delanghe from the Ghent University Hospital on microalbuminuria as an early indication of renal damage and the benefits of a simplified diagnosis.

Why is it important to monitor microalbumin?

PROF. JORIS R. DELANGHE: Microalbuminuria occurs in a phase in which the renal damage can still be reversed provided appropriate medication is prescribed. The efficiency of screening programs for diabetes and arterial hypertension is inadequate. Because CKD is one of the biggest threats to public health in the 21st century, microalbuminuria is becoming increasingly important.

What role does creatinine play in combination with albumin?

PROF. JORIS R. DELANGHE: Monitoring the amount of urine that is excreted every day with regard to the albumin dilution poses an organisational problem. Creatinine lets you include the variation of the diuresis. Creatinine is produced in a constant amount in the human body and is an excellent reference substance to express the urine concentration in numerous analytes. The albumin-to-creatinine ratio (ACR) permits the use of spontaneous urine samples.

What is the advantage of measuring microalbumin with a standard urine test strip over an albumin-specific test strip?

PROF. JORIS R. DELANGHE: Microalbumin tests are quite expensive on the European IVD market because this is essentially an immunochemical test that calls for the use of costly antibodies. The Sysmex MEDITAPE UC-11A and MEDITAPE UC-12S urine test strips, however, can easily be used in routine clinical laboratories. They are very precise – and reasonably priced.

How did the Sysmex test strips fare with respect to the detection of microalbuminuria?

PROF. JORIS R. DELANGHE: The test strips convinced us where others failed: they can detect microalbumin from a level of 5 mg/l and are thus sensitive enough to reliably differentiate between microalbumin positive and negative samples in the diagnostically relevant range too. The combination with state-of-the-art CMOS technology, as used in the UC-3500 and UC-1000 test strip analyser, means a quantum leap for affordable albuminuria tests.

  • Delanghe JR, Himpe J, Decock N, Delanghe S, De Herde K, Stove V, Speeckaert MM. Sensitive albuminuria analysis using dye-binding based test strips. Clin Chim Acta 017;471:107-112
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