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Kidney Diseases

Microalbumin/creat ratio +urinemicralbumin qn

08/29/2008

Question:

The first test for the above question was done at the time I passed a small kidney stone. I had a calcium level of 11.3. The micro level for ua creatinine is 227.9 micralbumin ratio 39 urine micralbumin qn 89.3. I am diabetic with an a1c level of 6.2 down from 6.3 six months ago. Are the results inconclusive? I am sched. to see endocrinologist 9-11-08 for referral of probable hyperparathyroid. Does this play a part? Blood creatinine, bun are normal. Bun/creat ratio 15.6. What`s up? Should I see a urologist? Thanks for the help.

Answer:

Your elevated microalbumin/creatinine ratio probably is not related to the kidney stone or to your hyperparathyroidism. Elevated amounts of albumin in the urine, as measured by this ratio, usually indicate a very early stage of kidney damage, most likely due to the diabetes. At this early stage, further damage can sometimes be prevented by improving diabetic control and by giving certain medications such as an ACE inhibitor (e.g., lisinopril) or ARB (e.g., losartan). You should check with your primary physician, who may want to refer you to a nephrologist for further advice and management. You probably do not need to see a urologist unless you continue to pass kidney stones, or unless renal imaging (such as an ultrasound or a CAT scan) shows that more unpassed stones are in your kidney.

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Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University