Microalbuminuria.

Nephropathy progressing to end-stage renal failure is a common complication of diabetes mellitus. The development of diabetic nephropathy is preceded for many years by minor increases in urine albumin excretion (microalbuminuria), and some diabetologists believe that by reducing or reversing this early abnormality, possibly by more rigorous control of hyperglycemia or by correcting glomerular hemodynamic abnormalities, the later development of frank nephropathy might be delayed or prevented. Once frank nephropathy has developed, its progress to renal failure is little, if at all, influenced by therapy. The early detection of microalbuminuria is therefore important for the management of diabetic patients, and its measurement should be available to all diabetologists. Sensitive, precise, and accurate methods are readily available to most laboratories. The preferred specimen is a 24-hour collection of urine or a timed overnight collection. A quantitation corrected for creatinine on a first-morning specimen may be a sufficiently sensitive test to detect those patients who should be subjected to a more extensive collection. Whether random samples taken at other times of the day are also suitable for screening remains to be proved.