Study of Various Measures of Urine Albumin Excretion in 24-Hours Urine and Their Clinical Outcome in Type 2 Diabetic Patients Chavan Vilas U.1,*, Durgawale Pushpa P.2, Sontakke Ajit V3, Lad Hasit D1 1Associate Professor, Department of Biochemistry, A-Block, Surat Municipal Institute of Medical Education & Research (SMIMER), Opp. Bombay Market, Umarwada, Surat-395010, Gujarat, India 2Professor, Department of Biochemistry, KIMS, Karad-415110, Maharashtra, India 3Professor and Head, Department of Biochemistry, KIMS, Karad-415110, Maharashtra, India *Corresponding Author: E-mail: drvuchavan@yahoo.co.in
Online published on 21 March, 2015. Abstract Background Microalbuminuria (MAU) has been considered the first indication of renal injury in patients with diabetes and associated with a higher cardiovascular risk. It is evident from epidemiological studies that urine albumin concentration (UAC) or albumin: creatinine ratio (ACR) in spot urine sample gives similar result like 24-hour urinary albumin excretion (UAE). Objectives The study was aimed to find out whether UAC and/or ACR calculated in 24-hour urine sample correlate or not with same 24-hour UAE and what is diagnostic outcome by various measures of albumin excretion calculated in 24-hour urine samples in type 2 diabetic patients? Methodology We collected 24-hour urine sample from 125 type 2 diabetic patients and urinary albumin and creatinine were measured. We calculated different parameter of albumin excretion in 24-hour urine sample and interpretation of each parameter was derived. Data was expressed as median and range. Results The median ACR was 187.30 (mg/g), UAC was 135.5 (mg/L) and UAE was 270.92(mg/24 hours) in 24-hours urine sample. Clinical outcome of nephropathy by different calculated measures of albumin excretion in 24-hour sample was different. 72 patients had similar interpretation while 53 patients showed different diagnostic interpretation by different measures of albumin excretion in the same 24-hour urine sample. Conclusion Various measures of urine albumin excretion like UAC, ACR calculated in 24-hour urine sample in type 2 diabetic patients showed different diagnostic interpretation. We recommend when the urinary albumin concentration exceeds 10 mg/L in spot or random urine sample, another 24-hour sample should be collected for confirmed diagnosis of the stage of the albuminuria/nephropathy. We conclude that 24-hour urine sample is gold standard for diagnosis of nephropathy in diabetic patients. Further prospective studies are needed to confirm our findings. Top Keywords Microalbuminuria, Type 2 diabetes mellitus, Urine albumin concentration, albumincreatinine ratio, Urinary albumin excretion, 24-hour urine, Diabetic nephropathy, Measures of albuminuria. Top |