Urine microalbumin

Do you have diabetes or high blood pressure? They can damage the kidneys for years without causing any symptoms. The microalbumin test detects very small amounts of the protein albumin in urine, one of the earliest signs of kidney damage, at a stage when it can still be slowed.

Who the test is intended for

• people with type 2 diabetes, once a year from diagnosis;
• people with type 1 diabetes, once a year, usually after five years of disease;
• people with high blood pressure;
• people with chronic kidney disease or reduced eGFR;
• people with cardiovascular disease or multiple risk factors, as assessed by a doctor;
• for monitoring the effect of kidney-protective treatment.

What the test reveals

Albumin is the main blood protein, and healthy kidneys allow only traces into urine. When the small blood vessels in the kidneys begin to be damaged, most often because of high blood sugar or pressure, urine contains more albumin. These amounts are too small for a standard dipstick to show, but this test detects them.

Elevated urine albumin is also a sign concerning blood vessels in general: it is associated with a greater risk of heart attack and stroke. The term “microalbuminuria” is used less often today, while guidelines refer to moderately increased albuminuria.

What the test involves and how to prepare

A single sample is most often submitted, preferably first-morning midstream urine. The doctor sometimes requests urine collected over 24 hours. You do not need to fast. Bring the sample as soon as possible, ideally within 2 hours.

Avoid strenuous training the day before and drink as usual. It is better to postpone the test during menstruation, fever or a urinary tract infection, as these temporarily increase urine albumin. State which medicines you take.

What your result means

The report shows the measured amount of albumin in urine, and the reference interval printed on the report applies. International guidelines (KDIGO) describe albuminuria categories using the urine albumin-to-creatinine ratio. This ratio is not printed on the report: the doctor calculates and interprets it, and the approximate categories are:

• below 3 mg/mmol (in 24-hour urine, below 30 mg per day): a normal result. In diabetes and high blood pressure, the test is repeated once a year.
• from 3 to 30 mg/mmol (30 to 300 mg per day): moderately increased albumin, previously called microalbuminuria. It is an early sign of kidney damage and greater cardiovascular risk.
• above 30 mg/mmol (above 300 mg per day): severely increased albumin, a sign of more pronounced kidney damage that the doctor investigates further, often with a nephrologist.

A single elevated result is not a diagnosis. Exertion, fever, infection and poorly controlled blood sugar temporarily increase urine albumin, so kidney damage is confirmed only when at least two of three samples are elevated over three to six months. The doctor interprets the report alongside creatinine and eGFR, blood pressure and HbA1c.

How to arrange testing

The test is performed without a referral or appointment: you can submit a urine sample at any of our branches (listed on the Contact page). Prices for all tests and panels are available in the price list.

Frequently asked questions

What is the difference between microalbumin and total urine protein?

Microalbumin testing measures albumin only and detects very small amounts, so it is used for early detection of damage. Total urine protein measures all proteins and is used when the loss is already greater.

Why was the dipstick normal while microalbumin was elevated?

The dipstick in urinalysis reacts only to greater amounts of protein. Microalbumin testing is more sensitive and detects damage earlier.

Can elevated urine albumin be reduced?

Yes, especially when detected early. Good control of blood sugar and pressure, stopping smoking and kidney-protective medicines prescribed by a doctor can reduce urine albumin and slow damage.

How often should the test be repeated?

In diabetes and high blood pressure with a normal result, usually once a year. When albumin is elevated, the doctor determines more frequent follow-up according to the result and treatment.