Saving Kidneys With Simple Testing

| Feb 1, 2005

In November 2004, the International Society of Nephrology (ISN) asked national health bodies around the world to consider the urgent implementation of proactive albumin (protein) screening in urine.

The ISN says that doing so will allow for early detection of kidney damage, followed by treatment to prevent further deterioration of the kidney, thus reducing the number of patients suffering from kidney failure, heart failure and diabetes.

“We believe that early detection of [kidney] impairment, followed by preventive treatment, is now a global health priority,” says professor Jan J. Weening, president of the International Society of Nephrology. “We now know that simple testing for albuminuria is extremely efficient as an early indicator of renal malfunction. It is essential that high-risk patients are systematically screened in the immediate future and advisable to extend this to the public at large as a second step.”

Professor Dick de Zeeuw, head of the department of clinical pharmacology at the University Medical Centre in Groningen, the Netherlands, adds that patients with albuminuria are not only at risk for kidney failure but also for heart failure and for developing diabetes. Positive levels of albumin in the urine indicate a generalized cardiovascular risk.

Source: The International Society of Nephrology

Did You Know?

Kidney failure, heart failure and diabetes account for the major portion of healthcare budgets today.

Source: The International Society of Nephrology

Did You Also Know?

More than 60 million individuals worldwide are estimated to have some degree of chronic kidney disease.

Source: The International Society of Nephrology

Clinical adviser’s note:

A normal laboratory value for albumin in urine is less than 30 micrograms per milligram of creatinine. Abnormal results are microalbuminuria of 30 to 299 micrograms per milligram and macro (clinical) albuminuria of 300 or greater.

Due to variability in urinary albumin excretion, the American Diabetes Association recommends that two of three specimens within a three- to six-month period would have to test as abnormal before considering a patient to have crossed one of these diagnostic thresholds.

It should be noted that exercising within 24 hours of testing, infection, fever, congestive heart failure, marked high blood glucose levels and marked high blood pressure levels may elevate urine albumin excretion. Everyone with diabetes should have an annual test for kidney function starting at diagnosis for type 2s and generally four years after diagnosis for type 1s.

To help slow the progression of kidney impairment, angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) should be used for treatment. For more information about these drugs, which are generally used to treat hypertension, see our chart on page 52 of the January 2005 issue.

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Categories: Blood Glucose, Diabetes, Diabetes, Kidney Care (Nephropathy), Type 1 Issues, Type 2 Issues

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