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Diabetes

Microalbumin/Creatinine Ratio

02/07/2008

Question:

My husband got lab results from an exam when we wanted to up our life insurance that say he has a Microalbumin/Creatinine Ratio of 5620 when the normal range should be 0-20mg/g. He also has a protein quantitive of 766 when normal is 0-23mg/g. When I researched I thought maybe it was diabetes, but supposedly he does not have that. Wouldn`t these high readings indicate something serious? His father had bladder cancer and I thought maybe it was something like that, but each doctor I contact to see him has a waiting list of weeks!

Answer:

Microalbumin/creatinine ratio refers to the amount of albumin measured with a very sensitive assay that can detect in the microgram range is present in the urine.  When the filtration function of the kidney is working properly, there is a very limited amount of albumin in the urine.  As the filter becomes less selective, there is more loss of albumin in the urine and this ratio goes up.  Diabetes is one of the commonest causes of this sort of damage to the "filters" in the kidney (technically known as the renal glomeruli, the plural of glomerulus) but it is not the only cause.  When it is due to diabetes, it represents something that develops very gradually over a long period of time.  There are a number of other diagnoses that could contribute.  It is unlikely to be due to bladder cancer per se.  It might be good when trying to schedule with your doctor's office to tell them what the problem is that needs addressing.  Based on knowing other things about your husband's health, they may be able to judge how urgent it is that this be attended to, whether the timing they can manage is safe, and whether they may want to do some other testing beforehand.  There can be abnormal readings with this test that result from vigorous exercise and go away when re-tested without such exercise, so it is important to make sure that that was not a factor at the time this sample was collected.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati