Albuminuria is a major risk factor for progressive renal function decline and is believed to be the initial step in an inevitable progression to proteinuria and renal failure in humans. Thus reduction of albuminuria is a major target for renoprotective therapy in CKD. Moderately increased albuminuria (previously microalbuminuria) is arbitrarily defined as excretion of 30 to 300 mg albumin/24 h in at least two of three consecutive urine samples. At concentration of 30 to 300 mg/24 h, albumin is normally not detected by nonspecific tests for protein (e.g., Biuret reaction). Albumin can be detected, however, by use of specific techniques such as dipstick, enzyme-linked immunosorbent assay, nephelometry, and radioimmunoassay. Instead of difficult-to-obtain 24-hour urine collections, the albumin concentration can be determined in spot urine or, better, first-void morning urine samples. The normal range is less than 20 µg/ml. Satyendra Dhar MD, @DharSaty #albuminuria #esrd #ckd #kidneys
