Kennebec Region Health Alliance

Promoting Healthy Communities Since 1997

Screening of Urinary Albumin Excretion in Diabetic Patients

Author: Elias Lemoine, DO MaineGeneral Kidney Care
Date: 5.11.2016.

Who to screen, How often do you screen, What test to order, Result interpretation, How often is the test repeated.

  1. Who to screen:
    1. Patients with type 1 diabetes starting five years after onset
    2. Patients with type 2 diabetes starting at time of diagnosis
  2. How often do you screen:
    Both type 1 and type 2 diabetic patients should be screened yearly
  3. What test to order:
    Untimed urinary sample looking at urine albumin-to-creatinine ratio
  4. Result interpretation:
    1. The normal amount of albumin excretion is less than 30 mg /day
    2. Repeated results between 30 and 300 mg / day is called persistent or microalbuminuria
    3. Repeated results above 300 mg / day is called severely increased albuminuria or macroalbuminuria
  5. How often is the test repeated:
    Abnormal results should be repeated at least two times over 6 months to rule out false positives or transient microalbuminuria (causes include Fever, exercise, heart failure, and poor glycemic control)
    Two abnormal test results during the 6 month time frame establish the diagnosis of increased urinary albumin



  1. Standards of medical care in diabetes – 2015: summary of revisions. Diabetes Care 2015; 38 Suppl: S4.
  2. Qaseem A, Hopkins RH Jr, Sweet DE, et al. Screening, Monitoring, and treatment of stage 1to 3 chronic kidney disease: A clinical practice guideline from the American College of Physicians. Ann Intern Med 2013; 159: 835.
  3. Mogensen CE. Prediction of clinical diabetic nephropathy in IDDM patients. Alternatives to microalbuminuria? Diabetes 1990; 39;761.
  4. Mogensen CE, Vestbo E, Poulsen PL, et al. Microalbuminuria and potential confounders. A review and some observations on variability of urinary albumin excretion. Diabetes Care 1995; 18: 572.

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To promote the provision of efficient and effective healthcare services, Kennebec Region Health Alliance helps develop and disseminates practice guidelines for use by its member practices. Such guidelines are based upon various sources that KRHA believes to be reliable, which may include but is not limited to, guidelines from widely recognized professional societies, boards and colleges such as the American Medical Association (AMA). Practice guidelines are reviewed at least every two years and updated as necessary to reflect changes in medical practice.
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