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Kidney Diseases

High Microalb/Creat Ratio

04/30/2009

Question:

What does a reading of 132 on the microalb/creat ratio mean? does it mean kidney failure is already going on? Also, microalbumin urine is 241. I am male, age 76, and diabetic. Is this something that I need to worry about? The doctor does not tell me anything about my test.

Answer:

A ratio of 132 is above normal (normal is less than 30).  Note that the important number here is the ratio, not the urine microalbumin.  The elevated ratio means that your kidneys are leaking a small amount of protein, which is usually an early sign of kidney damage, presumably due to your diabetes.

However, the microalbumin/creatinine ratio does not tell you about the actual function of your kidneys.  When people talk about "renal failure," they generally are referring to the ability of the kidneys to get rid of waste products.  To measure kidney function in this sense, we use the BUN and serum creatinine.  See the article on "Kidney Tests" for more information on these and other tests.

If it turns out that your BUN and creatinine are normal, and only your urine microalbumin/creatinine ratio is elevated, then you are at a very early stage of kidney disease.  Elevation of the MA/creat ratio is often treated with meds called "ACE inhibitors" (which include meds like lisinopril, accupril, enalapril, quinapril).  At this stage, careful treatment may actually be able to slow or prevent kidney damage from progressing.

Other important things for you to do at this point to prevent further kidney damage are to keep your diabetes, blood pressure, cholesterol, and weight under excellent control, and to avoid (or stop) smoking.

Related Resources:

Kidney Tests

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Response by:

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