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Diabetes

Results of microalb/creat ratio

04/23/2007

Question:

My results are very troublesome to me. My creatinine,urine is 207.6 My microlbumin is 843.0 and my microalbumin/creat ratio is 406.1. Can you tell me how bad the levels are before they put me on dialysis. I do see a renal doctor and scheduled an appt. as soon as i got these results but id like your help to ease my mind. Thank You so much for your help...please answer asap im freaking out.....

Answer:

You don't mention what the nature is of your kidney problem and what other associated conditions you may have.  The microalbumin/creatinine ratio is a measure of how leaky the primary filters (called the glomeruli) are in the kidney.  When I say leaky, I mean that the filter lets through large molecules where normally it would let through only small molecules.  The key piece of information that you provide is the microalbumin/creatinine ratio.  The normal range for that ratio is less than 30.  The range 30 to 300 is referred to as "microalbuminuria" while values above that qualify for what is called the nephrotic syndrome.  There can be a number of factors which can cause or contribute to the nephrotic syndrome, diabetes being one of them.  The cause is a determinant as to whether a given person's nephrotic syndrome has a reversible component.  Another measure of kidney function, the glomerular filtration rate, which we estimate from the concentration of creatinine in the blood, is really the determinant of how close a person is to needing dialysis.  Progression to nephrotic syndrome increases the likelihood of further progression to dialysis but does not guarantee it.

I understand that this all sounds scary and it could mean changes that you may need to make in your life.  Its appropriate and "okay" to be scared - but it is important to then take control of the situation and figure out what your choices are and see what choices seem best for you.  That's another way of saying once you've freaked out, you have to calm down and take a look at the situation and be able to make some good, well thought out decisions.  Good luck and, by all means, feel free to write back.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati