Urine analysis for Mau decoding. UIA urine test: normal in adults, albumin is elevated, what does it mean

Why might you need a urine test for UIA? First of all, to identify possible problems associated with the kidneys, as well as for the early diagnosis of atherosclerosis and other diseases.

A urine test for Mau is to obtain information about the amount of albumin, one of the types of protein present in the blood plasma. The greater his losses, the greater the likelihood that a problem has arisen that will need to be urgently resolved. Why do you need to take a urine test? Because albumin is excreted only through the vessels of the kidneys.

And therefore, a reduction in its amount in the body can lead to the risk of developing kidney disease, such as the initial stage of atherosclerosis or endothelial dysfunction, as well as diabetes.

The result of a correct analysis of the amount of albumin in excreted urine can reveal the disease microalbuminuria, which exhibits low concentrations. Healthy kidneys retain most of the albumin, leaving only a small portion in the urine.

In order to check the exact amount of albumin in the urine, both daily and routine analysis may be required. This will allow the doctor to make the most accurate diagnosis by sending you for a urine test to detect microalbuminuria.

Since Mau will reveal the presence and degree of concentration of albumin in the urine, it will be prescribed only in the most extreme cases, when it is not possible to conduct research using conventional methods.

In what cases are examinations required?

Most often, collection of samples for Mau is required if necessary to conduct an examination of diabetic nephropathy. And also when monitoring during the course of the disease. This will allow you to monitor and identify the slightest deviation from the norm. Medical statistics state that 40% of patients diagnosed with insulin-dependent diabetes mellitus require control.

As a norm, a healthy person can excrete no more than 30 mg of albumin per day. This means that each liter of urine should contain within 20 mg in a single analysis.

Moreover, if, as a result of a correctly conducted examination, the transcript does not indicate the presence of an infection occurring in the urinary tract, then this may require additional examination and testing. If a high level of protein is detected, this will indicate the presence of pathology in the glomerular renal apparatus. Research on Mau will allow us to monitor the excretion of this type of protein from the body. And only a urine test for microalbuminuria or diabetes can help.

The main factors that can influence the establishment of protein levels

Today, the main factors that allow us to determine the exact amount of albumin in urine are various research methods. First of all, to get the correct result you will need to obtain urine, which must be collected within 24 hours. In this case, most often only the morning portion is taken as a basis. The one that was collected 4 hours before lunch can be used. This will allow, if necessary, to identify the excreted proportions of protein and creatinine.

Two interrelated processes continuously occur in the kidneys - filtration and reabsorption. From the blood passing through glomeruli of the kidney , primary urine is filtered, which receives a large amount of salts, sugar, proteins and trace elements. Then, in a healthy body, the necessary substances are reabsorbed.

With the development of pathology of the urinary system, diseases of the heart and blood vessels of the system, proteins are removed from the body. Microalbuminuria occurs.

What it is? Microalbuminuria- this is a symptom in which special proteins - albumins - are found in the urine in an amount of 30 to 300 mg / day.

The role of albumin in the human body

Proteins, in particular albumins, are the main material for all cells of the body. They maintain the balance of fluid and microelements between cellular and extracellular structures. Albumin is necessary for the functioning of all organs and systems.

Most proteins are synthesized from amino acids in liver cells. After this, they enter the systemic circulation and are distributed throughout the body. The synthesis of some proteins requires essential amino acids from food. The loss of such proteins in the urine is observed in serious pathologies and threatens the body with serious consequences.

24-hour urine analysis and albuminuria

Since at the initial stage microalbuminuria may not manifest itself in any way, it becomes of great importance 24-hour urine test.

Why should you prepare for a urine test?

To avoid false positive results, beforehow to get tested, it is necessary to prepare:

• alcohol intake is excluded for two days;
• Protein-rich foods (meat, legumes) are consumed in the usual amount for a particular person;
• before collecting urine, toileting of the genitals without the use of disinfectants;
• women need to close the vaginal opening with a sterile cotton wool or gauze swab;
• collection of analysis begins with the second portion of urine, the first urination carried into the toilet;
• all urine during the day going into a large sterile container with divisions indicating volume;
• the urine container should be stored in the refrigerator;
• after 24 hours, the urine is mixed, 100 ml of urine is taken into another sterile container and delivered to laboratory for microscopy.

It is important to collect all portions of urine in full for daily analysis, since the level of MAU in urine can change during the day.

Difference between the terms microalbuminuria and macroalbuminuria

Proteinuria divided into several types depending on the amount of protein detected. Detection in daily urine traces protein (less than 30 mg albumin) is normal and does not require treatment. When the amount of albumin ranges from 30 to 300 mg/day, a diagnosis of microalbuminuria is made. If more than 300 mg/day of albumin is found in the urine,macroalbuminuria. Microalbuminuria is often one of the first signs of the disease, while others symptoms there are no diseases.Macroalbuminuria same often appears in the advanced stage of the disease.

Indications for determining microalbuminuria in 24-hour urine

Patients for whom analysis daily allowance urine test for UIA is mandatory:

• sick diabetes mellitus 1st and 2nd types;
• patients with arterial hypertension;
• patients with chronic kidney disease;

Norms of protein in urine for adults (men and women)

To determine the excretory function of the kidneys, it is not the total number of albumins in the urine that matters, but index ratio of albumin to creatinine. In adult men this indicator normally equal to 2.5 g/mmol, among women – 3.5 g/mmol. If thisindicator increased, this may indicate developmentrenal failure.

Need for more research

UIA is more often detected incidentally during decoding general urinalysis during medical examination. After that the doctor prescribes daily allowance urine test for microalbuminuria. For some chronic diseases daily Urinalysis should be performed regularly to monitor treatment and prevent complications. In such cases, determining the exact amount of albumin is not required, which means that as a screening method Two types of test strips can be used – quantitative and qualitative.

Quality test strips change color when immersed in urine containing albumin. If the strip does not change color, Means, protein content in urine less than 30 mg.

Quantitative test strips for UIA, when lowered into urine, change their color depending on the albumin content. The packaging shows a color scale and indicates how many albumins correspond to which color. By comparing the color of the test strip and the color of the scale, you can determine the approximate content of albumin in the urine or its absence.

What might a slight excess of protein in urine indicate?

UIA can be observed in a number of serious diseases, such as:

• diabetes ;
• arterial hypertension;
• atherosclerosis;
• chronic renal failure;
• nephropathy of smokers;
• tumors;
• urolithiasis disease.

In rare cases, microalbuminuria develops in the absence of disease.

Non-pathological causes

If protein is detected in the urine doctor gives a direction to retake the analysis, since cause microalbuminuria may be due to protein molecules entering a container with urine during analysis collection.

In addition, a small amount of protein may appear in the urine due to the following: reasons:

1. If the patient's diet is rich in protein foods of plant or animal origin.
2. After taking certain medications, such as anti-inflammatory drugs, a short-termincrease in albuminurine. Before taking the test, you should consult with doctor regarding the withdrawal of medications taken for several days.
3. After intense physical activity, the body breaks down large protein molecules into smaller fragments, which can pass into the urine through the kidney filter.
4. During pregnancy Some protein may be found in the urine. Normal albumin value in daily urine in pregnant women is no more than 500 mg. If quantityalbumin levels increased, this may indicate a risk of developing preeclampsia in a woman.
5. African Americans have severalincreased albumin content in urine can be considered the norm.
6. During ARVI and other acute infectious diseases, when the temperature rises to 39 degrees, permeability increasesglomerular vessels of the kidneys. Through these vessels proteins are filtered. As the febrile reaction resolves, microalbuminuria decreases.
7. Orthostatic microalbuminuria may occur in some children and adolescents. With this syndrome, the amount of albumin in urine collected in a standing position exceeds the norm. At the same time, in the analysis collected in the supine position,the level of albumin in urine is determined. Causes Orthostatic MAU is unknown; it is usually associated with a congenital anomaly of the renal vasculature.

In other cases, a more thorough examination of the patient using moderndiagnostic methods to identify the cause of UIA.

Diabetes

During development diabetes mellitusTypes 1 and 2 increase level blood sugar, called hyperglycemia. Long-term hyperglycemia leads to damage to large and small vessels the whole body. Microangiopathy also develops in the kidneys, causing diabetic nephropathy . With this syndrome, the wall of the renal tubules ceases to perform its function and becomes permeable to large protein molecules. UIA becomes the first sign of kidney damage.

Sick diabetes mellitus must be tested for UIA at least once every six months to promptly detect development nephropathy and provide appropriate treatment. During developmentdiabetes mellitus 1st type first microalbuminuria testsurrenders after 5 years from the onset of the disease, withdiabetes mellitusType 2 – immediately after diagnosis.

Cardiovascular diseases

In hypertension, narrowing occurs vessels organs and tissues, increased blood flow, increased blood pressure inside vessel Vascular damage kidney, called hypertensive angiopathy, leads to excessive pathological filtration of proteins through the wall glomeruli of kidneys . The presence of UIA increases stage hypertension and the risk of complications –renal failureand nephrosclerosis (wrinkling of the kidney).

With atherosclerosis, fat deposits occur in the form of atherosclerotic plaques on the walls vessels . The affected wall becomes permeable to proteins and some blood elements.

Chronic kidney infections

Chronic pyelo- and glomerulonephritis can be reason detection of protein in urine. In infectious diseases, the permeability of the glomerular apparatus increases and the process of reabsorption of urine is disrupted. Protein entering the primary urine is not reabsorbed back.

Since there may be no symptoms during treatment for chronic kidney disease, microalbuminuria may serve indicator , which evaluates the course of the disease and the effectiveness of therapy.

Urolithiasis disease

Microalbuminuria may be the first sign of the development of urolithiasis. Sand and small stones cause damage to the kidney filter, and the secretion of proteins into the urine increases. When the wall of the urinary tract is damaged, its microscopic components containing protein can also penetrate into the urinary tract. urine

Microtraumas of the genitourinary system

With microscopic injuries of the urinary tract, the processes of secretion and reabsorption in the kidneys are not impaired. Protein in urine is detected due to the components of the cell wall of the affected areas of the urinary system.

Cancer of the urinary system

Microalbuminuria may be the first sign of a malignant tumor of the urinary system in the earlystages of development. Cancer cells have invasive growth. They grow into the walls vessels and urinary tract, causing damage. Albumin penetrates into the urine through the damaged membrane.

Smoking

Heavy smokers who smoke more than one pack of cigarettes a day have dangerous concentrations of nicotine in their blood. Nicotine acts on the inner layer of the glomerular membrane, increasing its permeability to protein molecules. With constant exposure to nicotine, chronicrenal failure.

If you have a UIA, you need to find reason pathological syndrome. Development is excluded firstdiabetes mellitusand hypertension.

For diabetes mellitus characteristic:

• increased glucose levels in venous blood more than 6.5 mmol/l;
• level up glycated hemoglobin.

Hypertension is characterized by:

• promotion blood pressureabove 140/90mmHg. Art.;
• increase in the amount of cholesterol in the blood;
• increase in triglycerides.

Maintaining normal blood glucose level, blood pressure, cholesterol and fats, quitting smoking and drinking alcohol, reducing carbohydrates in the diet contribute to the prevention andtreatment of microalbuminuria.

Microalbuminuria appears at the initial stage of development of many serious diseases, so healthy people need to undergo regular medical examinations and a general urine test. In the presence of pathology from thecardiovascularand endocrine systemurine test for albuminshould be appointed doctor at least once every six months, so as not to miss the progression of the disease and to select the necessary treatment.

One of the main and irreplaceable functions of the kidneys is their unique ability to remove toxic metabolic products from the body in the form of urinary sediment. The glomerular and tubular apparatus of the organ is in constant work, “driving” blood through itself and cleansing it of all harmful and unnecessary impurities. In this case, all useful components (proteins, glucose and others) are re-entered into the bloodstream.

Urine is the final product of human life; it contains the following components: uric acid, ammonia, urea, salts, creatinine and others.

If for one reason or another the filtration capacity of the kidney tissue suffers, namely the permeability of the glomerular membranes increases, then substances useful to the body begin to be released in the urine.

One of the first “alarm bells” indicating the onset of pathology is an increase in the concentration of microalbumin in the urine. Normally, the synthesis of this protein occurs in liver cells. The share of albumin in blood plasma accounts for approximately 50-60% of all protein components. Their main task is to maintain a constant osmatic and oncotic pressure in the circulatory system, which is ensured by binding a water molecule.

A urine test for microalbuminuria (MAU) has the goal of early (preclinical) diagnosis, when the patient still has no symptoms associated with impaired renal function. This allows you to most effectively fight diseases and timely correct pathological processes.

Norms of laboratory parameters

The detection of albumin in urine is not always an indicator of the onset of a pathological process. Microalbumin is the smallest protein fraction, so even in a healthy person, a small amount of it can penetrate through intact glomeruli. While larger albumin molecules can never be detected in normal urine samples. In children, even a minimal increase in protein in the urinary sediment indicates the onset of pathology.

Before you begin to decipher the received data, it is necessary to clarify which numbers do not go beyond the physiological values:

• the norm of albumin, which a specialist can detect when examining urinary sediment, should not exceed 30 mg per day (if the values ​​​​exceed these values, then we are talking about microalbuminuria, while daily excretion of more than 300 mg of protein indicates proteinuria);
• the norm of microalbumin, determined in a one-time (single) portion of urine, does not exceed 20 mg/l
• the albumin/creatinine ratio is assessed in a random sample of urine; normal values ​​should not exceed the following figures: in women - up to 2.5, and in men - up to 3.5. If these indicators increase, one can judge the onset of nephropathy.

Reasons for the appearance of albumin in urine

Natural factors

Microalbumin in urine can exceed its concentration for completely natural reasons and is completely reversible:

• Drinking a large amount of liquid the day before, resulting in an increase in water load on the kidneys, strengthens the filtration mechanism. The same thing happens if a person eats too much watermelon.
• Excessive physical activity or intense sports activities lead to increased blood circulation, and therefore to increased functioning of the kidneys, which cannot always cope with this.
• Nicotine and its excess consumption have an adverse effect on the cellular structures of the entire body, and on kidney tissue in particular.
• The following factors can temporarily increase the permeability of the glomerular membranes: hypothermia or prolonged exposure to hot conditions, swimming in ice water, severe nervous strain or other mental disorders.
• Albumin can be detected in the urine of a girl during menstruation, so testing is not recommended during this period.
• After sexual intercourse, a woman’s tests can detect a substance called albumosis, the source of which is the partner’s sperm. Less commonly, it appears during massive cell breakdown in the body (for example, with gangrene or lung cancer).

Kidney “volume” overload is the cause of temporary microalbuminuria

In all the situations described above, a urine test for UIA will be considered a false positive, because after eliminating the underlying causes, laboratory parameters are completely normalized.

Pathological factors

Most often, the level of protein in the urine is increased due to a number of diseases of an infectious or non-infectious nature, the cause of which lies not only in kidney disease:

• Acute and chronic forms of glomerulonephritis or pyelonephritis (the appearance of protein components in the urinary sediment has varying degrees of severity).
• Nephrosis or nephrotic syndrome (especially in the lipoid form).
• Hypertension and varying degrees of heart failure.
• Atherosclerotic processes affecting the glomerular apparatus of the kidneys and the vessels of the organ.
• Diabetes mellitus, which causes diabetic nephropathy.
• Chronic form of alcoholism or long-term experience of nicotine addiction.
• Poisoning with nephrotoxic drugs or heavy metal salts.
• Preeclampsia during pregnancy, which threatens the life of the fetus and mother.

Preeclampsia is an extremely dangerous disease in a pregnant woman, an early sign of which is an increase in albumin in the urinary sediment.

Process stages

As mentioned above, the repeated appearance of albumin in the urine in concentrations exceeding normal levels is a direct symptom of the onset of nephropathy (normal kidney function is disrupted). In its development, the condition goes through several stages:

• Asymptomatic stage– the patient has no complaints of a “renal” nature, however, there are already initial changes in the urinary sediment.
• Stage of initial manifestations– there are still no complaints, but microalbumin appears in the urine.
• Stage of prenephrotic changes– the patient begins to notice instability in blood pressure numbers, the filtration rate in the kidneys decreases, the urinary sediment contains albumin in a concentration of 30 to 300 mg/day.
• Stage of nephrotic changes– the patient has severe edema, instability of blood pressure and a tendency to increase it, decreased filtration capacity of the kidneys, proteinuria, microhematuria.
• Stage of uremia - the patient develops edema, and blood pressure numbers increase significantly, which are difficult to treat, glomerular filtration sharply decreases, hematuria and massive proteinuria occur.

Who is tested for albuminuria for preventive purposes?

• diabetes mellitus (types 1 and 2);
• hypertension (especially in patients with a long history of hypertension);
• patients undergoing several courses of chemotherapy to treat cancer.

In pregnant women with an increased risk of developing preeclampsia, urine testing for UIA is included in the diagnostic standards.

How to properly collect urine for research?

It is necessary to understand that a single detection of elevated albumin levels in the urine is not a reason for making a particular diagnosis. Especially if you had to collect a random portion of urine.

Nephropathy can be judged by repeated determination of microalbumin in tests in patients who have undergone preliminary preparation before the study

At the beginning of each urine collection, it is necessary to thoroughly clean the genitals. Women are advised to use cotton swabs to prevent the penetration of the substrate from the vaginal lumen.

Urine is collected throughout the day into the same sterile container, from which the specialist then takes the volume required for the study.

Methods for correcting microalbuminuria

The problem of microalbuminuria is dealt with by doctors of different specialties (therapists, nephrologists, gynecologists and others), therefore the approach to the management of each category of patients has its own characteristics.

For timely detection of UIA, great importance is attached to all preventive examinations and clinical monitoring of patients.

The basic principles of drug therapy include the following:

• Restoring serum glucose levels using insulin or hypoglycemic agents.
• Stabilization of blood pressure numbers (ACE inhibitors, diuretics and others).
• Correction of lipid profile with statins.
• In advanced situations, they resort to hemodialysis or prepare the patient for organ transplantation.

Conclusion

Early diagnosis of microalbuminuria is difficult, which is due to the complete absence of clinical manifestations that would “force” the patient to seek help from a doctor.

Urine testing to detect microalbuminuria (MAU) is widely used in the diagnosis of the initial stages of renal tissue damage.

What is important is the quantitative determination of the level of urinary albumin, which is directly proportional to the degree of damage to the renal glomerulus (the main structural element of the kidney).

Microalbuminuria is the excretion of albumin protein in the urine in quantities exceeding physiological values.

Table 1 - Definition of microalbuminuria. Source - RMJ. 2010. No. 22. S. 1327

• Show all

  1. Physiological and pathological albuminuria

  A healthy person excretes a small amount of protein molecules in the urine (up to 150 mg/dl), while the albumin content in it is less than 30 mg/dl.

  The amount of protein excreted in urine can vary widely at different times of the day. Thus, at night, the excretion of albumin in urine is approximately 30-40% less, which is associated with a low level of vascular pressure and a horizontal body position. This leads to a decrease in renal blood flow and the rate of filtration of urine in the glomerulus.

  In an upright position, the level of albumin excretion in urine increases, and after physical activity it can briefly be in the range of 30-300 mg/l.

  The amount of albumin excreted in urine may be influenced by the following factors:

  1. 1 Food high in protein;
  2. 2 Hard physical labor;
  3. 3 Urinary infection;
  4. 4 Circulatory failure;
  5. 5 Taking NSAIDs (non-steroidal anti-inflammatory drugs);
  6. 6 Severe bacterial infection, sepsis;
  7. 7 Pregnancy.

  Taking antihypertensive drugs from the group of ACE inhibitors, on the contrary, reduces albumin secretion.

  The rate of urinary excretion of albumin may also depend on age and race. Abnormal excretion of albumin in the absence of evidence of concomitant pathology of internal organs occurs in the elderly and Africans, and is often combined with excess weight.

  2. Urine analysis for UIA - indications for use

  Microalbuminuria (abbreviated MAU) is the earliest and most reliable sign of kidney tissue damage.

  Since it is impossible to determine it using routine methods, testing urine for microalbuminuria is included in the standards for examining patients at risk, primarily in patients with established diabetes mellitus and arterial hypertension.

  List of patients to be screened for microalbuminuria:

  1. 1 Patients with any type of diabetes mellitus and a history of the disease of more than 5 years (once every 6 months);
  2. 2 Patients with hypertension (once every 12 months);
  3. 3 Patients after kidney transplantation to monitor the development of rejection reactions;
  4. 4 Patients with chronic glomerulonephritis.

  3. Causes of damage to the glomerulus

  Among the main causes of damage to the renal glomeruli, and therefore microalbuminuria, are:

  1. 1 High glycemic level. MAU is the very first sign of diabetic nephropathy. The main mechanism for the occurrence of microalbuminuria in diabetes mellitus is hyperfiltration in the renal glomerulus and damage to the kidney vessels as a result of hyperglycemia. If left untreated, diabetic nephropathy rapidly progresses, leading to kidney failure and the need for hemodialysis. That is why every patient with diabetes mellitus should undergo a urine test for UIA at least once every six months, for early detection of nephropathy and its timely treatment.
  2. 2 High level of systolic pressure. Hypertension is a systemic disease that affects a large number of organs and systems, including the kidneys. In this case, MAU is a sign of the development of kidney complications - hypertensive nephrosclerosis, which is based on increased filtration pressure, tubulointerstitial fibrosis and increased permeability of the vascular wall to protein. MAU is a self-sufficient risk factor for the development of complications of hypertension.
  3. 3 Overweight, obesity, metabolic syndrome. Since 1999, WHO has defined microalbuminuria as one of the components of metabolic syndrome.
  4. 4 Hypercholesterolemia and hypertriglyceridemia, which lead to the development of generalized atherosclerosis. MAU in this case reflects the phenomena of endothelial dysfunction and is directly related to increased cardiovascular risk.
  5. 5 Chronic inflammation of the kidney tissue. The appearance of MAU (and proteinuria in general) is a prognostically unfavorable sign of the progression of glomerulonephritis.
  6. 6 Smoking. In smokers, the excretion of albumin in urine is approximately 20-30% higher (Nelson, 1991, Mogestein, 1995), which is associated with nicotine damage to the vascular endothelium.

  4. Method of determination

  Pathological albuminuria is not detected by routine methods of urine examination, for example, by acid precipitation.

  Given the significant daily variability in urinary albumin excretion, only the detection of MAU in two or three consecutive urine tests is diagnostically significant.

  For a urine screening test for UIA, it is permissible to use specially designed test strips, but in case of a positive test using rapid tests, it is necessary to confirm pathological albuminuria using methods that allow determining the albumin concentration.

  Semi-quantitative assessment is carried out using special strips - strip tests, where there are 6 gradations of albumin concentration in urine ("not detected", "traces" - up to 150 mg/l, more than 300 mg/l, 1000 mg/l, 2000 mg/l). l, and more than 2 thousand mg/l). The sensitivity of this method is about 90%.

  Quantitative determination is carried out using:

  1. 1 Determination of the ratio of creatinine and albumin (C/A) in urine;
  2. 2 Direct immunoturbidimetric method. The method allows you to estimate the albumin concentration by the turbidity of the solution obtained after the interaction of the protein with specific antibodies and the precipitation of immune complexes.
  3. 3 Immunochemical method using the “HemoCue” system (immunochemical reactions using anti-human antibodies). Albumin-antibody complexes lead to the formation of a precipitate, which is subsequently captured by a photometer.

  5. How to collect material for research?

  Collecting urine for research does not require prior preparation.

  Rules for collecting material:

  1. 1 Urine collection occurs over a full day (from 08.00 on the first day to 08.00 on the second day), the very first portion of urine must be poured into the toilet.
  2. 2 All urine excreted over 24 hours is collected in a single container (sterile). During the day, the container should be kept in a cool place in the absence of sunlight.
  3. 3 The daily amount of urine must be measured and the result recorded on the issued research referral form.
  4. 4 After this, the urine is mixed (this is necessary, since the protein can settle at the bottom of the jar!) and poured into a sterile container in a volume of about 100 ml.
  5. 5 The container is delivered to the laboratory as soon as possible.
  6. 6 All urine collected per day does not need to be sent to the laboratory.
  7. 7 Since the release of albumin depends on height and weight, these parameters MUST be recorded on the issued direction. Without them, urine will not be accepted for examination.

  6. What to do if microalbuminuria is detected?

  If, apart from microalbuminuria, no other pathology of internal organs has been identified, then it is advisable to conduct additional diagnostics to exclude diabetes mellitus and hypertension.

  For this, 24-hour blood pressure monitoring and a glucose tolerance test are required.

  In patients with MAU and previously diagnosed diabetes mellitus and/or hypertension, the following laboratory criteria must be achieved:

  1. 1 Cholesterol<4,5 ммоль/л;
  2. 2 Triglycerides (TG) up to 1.7 mmol/l;
  3. 3 Glycated hemoglobin up to 6.5%;
  4. 4 Systolic pressure<130 мм.рт.ст.

  This helps reduce mortality from cardiovascular complications by 50%. In patients with type 1 diabetes, the indicators are slightly different and are:

  1. 1 Glycated hemoglobin< 8,0%;
  2. 2 Blood pressure<115/75 мм.рт.ст;
  3. 3 Cholesterol up to 5.1 mmol/l;
  4. 4 Triglycerides up to 1.6 mmol/l.

  7. Prevention of UIA

  In order to prevent damage to kidney tissue, several rules must be followed:

  1. 1 Systematic monitoring of fasting glucose - normal levels are 3.5 - 6.0 mmol/l.
  2. 2 Daily blood pressure monitoring, which should not exceed 130/80 mmHg.
  3. 3 Quarterly monitoring of lipid profile indicators - with high levels of cholesterol and triglycerides, not only the formation of atherosclerotic plaques occurs, but also damage to kidney tissue;
  4. 4 Completely stop smoking and nicotine analogue cigarettes. Nicotine is dangerous for all blood vessels in the human body, including the kidney vessels. The risk of developing proteinuria in smokers is approximately 21 times higher than in non-smokers.

During an examination to make an accurate diagnosis, the doctor may direct the patient to take a urine test for microalbuminuria.

This test determines the amount of albumin in the urine. Albumin is one of the blood proteins. The term "microalbuminuria" is used when the concentration of this substance is low in the urine excreted.

Provided the kidneys are functioning normally, these organs retain albumin, which enters the urine only in small quantities. The excretion of this substance in the urine is hampered by the molecular size (69 kDa), negative charge, and reabsorption in the renal tubules.

The excretion of albumin from the body increases if damage occurs to the glomeruli, tubules, or charge selectivity of ion filtration. In the case of glomerular pathology, the amount of albumin that is excreted in the urine is much greater than in the case of tubular damage. Therefore, urine analysis for microalbuminuria is the main indicator of the presence of glomerular damage.

Detection of Mau is an important indicator in the diagnosis of diabetic nephropathy, as well as in the process of monitoring the course of the disease. This deviation from the norm is observed in almost 40% of patients with diabetes mellitus, who are dependent on insulin. Normally, no more than 30 mg of albumin is released during the day. This corresponds to 20 mg per 1 liter in a single urine sample. If urinary tract infections, as well as acute forms of other diseases, are not diagnosed in the body, the level of albumin in the urine above normal indicates the presence of pathology of the glomerular apparatus of the kidneys.

Mau is the level of albumin concentration in urine that cannot be detected by conventional analysis methods. Therefore, it is necessary to submit biomaterial for a special study.

Factors affecting urinary albumin levels

To determine the amount of albumin in urine, the following methods are used:

• isotope immunological;
• linked immunosorbent assay;
• immunoturbidimetric.

Urine collected over 24 hours is suitable for analysis. However, most often only the morning portion is handed over or the one that was collected over 4 hours in the first half of the day. In this case, the ratio of albumin and creatinine is determined, the norm of which in a healthy person is 30 mg/g or less than 2.5-3.5 mg/mmol.

When conducting screening, it is possible to use special test strips, which significantly speed up obtaining results. They have a certain sensitivity limit. However, in case of a positive result, it is recommended to re-test the urine for Mau in the laboratory.

In addition, it is worth considering that the release of albumin depends on the time of day. At night this amount is less, in some cases almost half. This is due to being in a horizontal position and, accordingly, lower blood pressure. The level of albumin in the urine increases after physical exercise and increased protein intake.

In the presence of an inflammatory process, for the treatment of which the patient takes anti-inflammatory drugs, the level of this substance in the urine may fall.

Other factors also influence this parameter:

• age (the norm for elderly patients is higher);
• weight;
• race (the rate is higher among representatives of the Negroid race);
• arterial pressure;
• presence of bad habits, in particular smoking.

It is precisely because the level of albumin in urine is influenced by a large number of different factors that exclusively persistent microalbuminuria is of great diagnostic importance. In other words, detection of microalbuminuria in three consecutive urine tests over a period of 3-6 months.

Indications

Indications for prescribing a urine test for Mau are:

• diabetes;
• arterial hypertension (persistent increase in blood pressure);
• kidney transplant monitoring;
• glomerulonephritis (glomerular nephritis).

How to prepare for the test?

There is no special preparation for taking a urine test for Mau. The rules for collecting daily urine are as follows:

1. Urine collection occurs throughout the day, but the first morning portion is removed. All subsequent ones are collected in one container (it must be sterile). During the day when the collection is taking place, store the container with urine in the refrigerator, where the temperature is maintained in the range from 4 to 8 degrees above zero.
2. Once the urine has been completely collected, its quantity must be accurately measured. Next, mix thoroughly and pour into another sterile container with a volume of 20-100 ml.
3. This container must be handed over to a medical facility as soon as possible. The peculiarity is that the entire collected volume of urine does not need to be brought. However, before passing urine, it is imperative to measure the exact volume of urine excreted per day - diuresis. Additionally, the patient's height and weight are indicated.

The day before taking your urine for Mau analysis, you must stop taking diuretics and alcohol, avoid stressful situations and excessive physical activity, and do not eat foods that affect the color of urine.

Interpretation of results

It is worth remembering that the results of a urine test for Mau are information for your attending physician, and not a full-fledged diagnosis. The norm depends on many factors and characteristics of the body. Therefore, if you receive the results yourself, you should not engage in self-diagnosis, but entrust it to a specialist.

An increase in albumin levels in the urine may indicate the presence of:

• arterial hypertension;
• kidney inflammation;
• glomerular nephritis;
• kidney rejection after transplantation;
• diabetes mellitus;
• fructose intolerance, which is congenital;
• hyper- or hypothermia;
• pregnancy;
• congestive heart failure;
• heavy metal poisoning;
• sarcoidosis (an inflammatory disease that affects the lungs);
• lupus erythematosus.

A false positive result can be observed if the patient has undergone significant physical activity the day before.