Various Methods to Detect Microalbumin in Early Detection of Nephropathy

Abstract

Background : Microalbuminuria (defined as urinary albumin excretion of 30-300 mg/day, or 20-200 µg/min) is an earlier sign of vascular damage. It is a marker of general vascular dysfunction and nowadays is considered a predictor of worse outcomes for both kidney and heart patients. Microalbuminuria could be taken also, as an indicator of insulin resistance and of the increased renal and cardiovascular risk associated with metabolic syndrome. Renal involvement is a pivotal development in diabetes and microalbuminuria is generally the first clinical sign of renal dysfunction in diabetics. It is demonstrated that cardiovascular and renal risk is elevated even in the high normal range of microalbuminuria (below 30 mg/day). Material and method; The cross sectional study was conducted in department of biochemistry and medicine in Guru Gobind Singh Medical College and Hospital, Faridkot. 50 patients, who suffering with diabetes and hypertensive were enrolled for study. Result; Out of 50 diabetes and hypertensive patients, 31 males and 19 females. The p values are not significant so all the 3 methods can be used for detecting microalbumin in diabetic and hypertensive patients. In our study we found that microalbumin by antigen antibody method as provided by point of care instrument (ICHROMA) gives sensitivity of 88% and specificity of 80.1%. Albumin creatinine ratio by laboratory method is cheap and simple method with sensitivity of 86.0% but specificity of 42.8% Conclusion: Albumin creatinine ratio by dye based strip method is a good marker to detect microalbumin in early detection of nephropathy in diabetic and hypertensive individuals. Microalbuminuria by antigen antibody reaction detection by ichroma provides good sensitivity and specificity. On the other hand ACR by lab method cannot substitute ACR by strip due to its low specificity.