Persistent albuminuria means that the kidney has some damage and is starting to spill some albumin-a kind of protein-into the urine. Two positive tests for albumin in the urine over several weeks indicate persistent albuminuria, a first sign of diabetic kidney disease.

Is diabetic kidney disease serious?

Kidney disease is one of the most serious complications of diabetes. After years of diabetes, the filtering units of the kidney-called glomeruli-get scarred and cannot filter the blood efficiently. Eventually, the kidneys may fail completely so that a person with the disease needs hemodialysis, peritoneal dialysis or a kidney transplant.

Are there tests that can tell if my kidneys have been hurt by diabetes?

Yes; a urine test for albumin and a blood test for creatinine. The results of the creatinine blood test should be used to estimate glomerular filtration rate (GFR), which is a measure of your level of kidney fuction.

How is albuminuria measured?

It can be measured by a specific urine test, either on a single urine specimen using an albumin-specific dipstick, or by a more precise urine test called your albumin to creatinine ratio. Sometimes a 24-hour urine collection may be done to measure albuminuria. Any doctor can test for albuminuria. Routine urine analysis does not detect albuminuria.

Who should have this test and how often?

Everyone with Type 1 and Type 2 diabetes who is between 12 and 70 years of age should have a urine test for albuminuria at least once a year. If positive, the result should be confirmed by a second urine test.

What would be considered a positive result?

In a single urine specimen, a level of more than 30 mg of albumin per gram of creatinine is considered positive. For a 24-hour urine collection, 30 to 300 mg of albumin means albuminuria.

Can anything besides kidney disease cause this test to be positive?

Yes; some other conditions such as high blood pressure can also cause albuminuria. If the test is done during periods of illness, heavy exercise, urinary tract infections or poor blood glucose control, it may show a positive result.

Is the test for urine albumin expensive? Is it covered by health insurance?

The test is relatively inexpensive and most health insurance plans will cover it.

Does a positive test suggest other problems besides kidney disease?

Albuminuria suggests a higher risk for heart disease as well as kidney disease.

What can be done to prevent diabetic kidney disease?

Tight control of glucose lowers the risk of all diabetic complications, including the development of albuminuria. Other measures are: keeping blood pressure under good control, quitting cigarette smoking and following a diabetic diet, as prescribed by a doctor.

Updated: 04/27/04

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See also in this A-Z guide:

• Hemodialysis
• Diabetes and Kidney Disease
• High Blood Pressure: A Look at the Causes
• How Your Kidneys Work
• Kidney Transplant
• Warning Signs of Kidney and Urinary Tract Diseases

All health information in this A-Z Guide has been approved for medical accuracy by the Scientific Advisory Board of the National Kidney Foundation. This information was current as of the date listed at the top of the page. Our Scientific Advisory Board members.

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©2006 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. No one associated with the National Kidney Foundation will answer medical questions via e-mail. Please consult a physician for specific treatment recommendations.