Microalbuminuria as predictor of outcome

Microalbuminuria is used clinically to monitor incipient diabetic nephropathy, but it is known also to be a non-specific marker of inflammation, both systemic and local,1^–3 and appears to be useful as a predictor of outcome in several clinical situations.4^–8 The equipment required to perform the test is small and mobile, each test taking two minutes to perform. Might a test for microalbuminuria provide a simple means of identifying patients whose condition will deteriorate across a range of clinical conditions?

Microalbuminuria is defined as a urinary albumin concentration of 30-200mg/l. These values are currently detectable by semiquantitative dipstick tests. In healthy volunteers spot testing of urinary albumin shows the mean concentration to be 5.1mg/l, with 95% of samples having a concentration of less than 29.6mg/l, regardless of time of collection.9

Microalbuminuria is thought to reflect the glomerular component of a systemic capillary leak10 that is fundamental to the pathogenesis of multiple …