Dissolved protein in the blood is critical to maintaining fluid balance, blood pressureand the movement of fluid from the extremities back to the heart.  One of the consequencesof not enough protein in the blood is the marked swelling that occurs in the ankles of people who are malnourished or have kidney disease in which protein leaks into the urine.  Every day the kidneys filter approximately 120 quarts of blood containing about 18 pounds of protein.  When the kidneys are through with their filtering and purifying process, a person excretes a quart and a half of urine from which the kidneys have removed all 18 lbs of blood protein leaving behind only two parts per million.  In other words, if protein were money, the kidneys would lose $2.00 for every million dollars it handled.  It is an amazing biological system.

     When you go the doctor and have a urinalysis done, a little stick of cardboard is dipped into the urine and can detect when the person has a 100 mg of albumin in the urine.   This would be the equivalent of detecting a $100.00 mistake for every million dollars processed.  But the sad truth is that by the time the urine dipstick in the doctor’s office is positive for protein, the disease process is already far advanced even though the person will have no symptoms.  Symptoms don’t really occur from the kidneys leaking protein until the kidneys are making the equivalent of $500.00 mistake for every million dollars managed.  By the time, a person has symptoms from kidney disease and seeks medication attention, the disease process is already far advanced most frequently being treatable but not curable.

     Thus enters the concept of microalbuminuria.  To break the word down, micro means “detecting something when it is very, very small” like with a microscope.  Albumin is the “major protein in a person’s blood", so we want to be able to detect very small amounts of albumin.  -Uria means “detecting something in the person’s urine”.  Thus microalbuminuria means detecting very small amounts of albumin in the person’s urine.  As mentioned above, the dipstick at the doctor’s office can detect a 300 mg of albumin in about one quart of urine.  The new special microalbuminuria test can detect anything greater than .03 mg of albumin in a quart of urine.  In other words, the microalbuminuria test can detect a $3.00 mistake a in a million dollars handled whereas the standard urine dipstick doesn’t see anything wrong until the kidney is having  leak equivalent to  a $300.00 mistake for each $1,000,000 handled.

     Why is this important?  It has now been shown that this tiny amount of albumin leak in the urine is a marker for the progression of kidney disease in diabetics, the progression of kidney disease in hypertensive individuals, the development of heart attacks, and the development of strokes.  In other words, those individuals that have very, very tiny amounts of albumin in the urine that they are not even aware of have joined a group of individuals that are destined for a markedly increased rate of kidney disease, heart attacks and strokes.

     So the next question would be how does one get this test done?  Simply go to the clinic and let the healthcare provider know that you want the microalbuminuria test done because of questions regarding heart attacks, strokes, diabetes, or high blood pressure and whether or not these factors are adversely affecting your health.  The test can be  done  at your local clinics and the result returned the same day.  If it should happen to be that the person’s urine is already positive by the doctor’s dipstick in the office, the microalbuminuria test is pointless because there is already substantial disease process involving the kidneys.

     If the test is easy and it is marker for disease progression, one might ask whether it is worth knowing.  In other words, if the test is abnormal is there anything that you can do about it.  The answer is an empathetic “yes”.   There are now multiple studies involving thousands of people showing that relatively simple medications not only reverse the amount of protein spilled in the person’s urine but also prevent progression of kidney disease in diabetics.  Note that kidney disease in diabetics is the the leading cause of a person having to have a kidney transplant or be treated with an artificial kidney for the rest of their life.  Living with an artificial kidney machine and all of its restrictions is not a fun way to live.  Preventing it is well worth the effort.

     Getting blood pressure checks and cholesterol checks provide the person with an index of factors in their life that are treatable to prevent disease. The microalbuminuria test adds a new dimension to this.  It will tell you the degree of damage that is occurring from the high blood pressure or from the high cholesterol or from the diabetes.  Since there are now very effective medicines to reverse the disease process and prevent its progression, the microalbuminuria test is very useful.  It can be done on a simple urine specimen left at the doctor’s office without the need for day long collections.  Once found it can be treated and used as a monitor to measure success.