Microalbuminuria: definition, detection, and clinical significance.
Microalbuminuria: definition, detection, and clinical significance.
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DOI：
10.1111/j.1524-6175.2004.4064.x
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发表时间：
2004-11-01
期刊：
影响因子：
--
通讯作者：
Toto, Robert D
中科院分区：
文献类型：
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作者：
Toto, Robert D
蛋白尿是肾脏异常排泄蛋白质的征兆，但它是一个非特异性术语，包括任何或所有排泄的蛋白质。相反，白蛋白尿特指白蛋白排泄率异常。微量白蛋白尿是指尿液中白蛋白排泄率在30-299mg/g肌酐范围内异常增加。它是内皮功能障碍和心血管发病和死亡风险增加的标志，尤其是但不限于糖尿病和高血压等高危人群。现在，通过办公室试纸测试（半定量）和广泛使用的实验室测试（定量）可以轻松检测微量白蛋白尿。医生应该对所有糖尿病患者进行蛋白尿筛查，并强烈考虑筛查高血压患者，以识别心血管疾病风险较高的人群。根据美国糖尿病协会和高血压预防、检测、评估和治疗国家联合委员会第七次报告的建议，在这种情况下，适当的干预措施，包括使用阻断肾素-血管紧张素-醛固酮系统的药物可能是合适的。
Proteinuria is a sign of abnormal excretion of protein by the kidney but is a nonspecific term including any or all proteins excreted. In contrast, albuminuria specifically refers to an abnormal excretion rate of albumin. Microalbuminuria refers to an abnormally increased excretion rate of albumin in the urine in the range of 30-299 mg/g creatinine. It is a marker of endothelial dysfunction and increased risk for cardiovascular morbidity and mortality especially, but not exclusively, in high-risk populations such as diabetics and hypertensives. Testing for microalbuminuria is now made easy by in-office dipstick tests (semiquantitative) and widely available laboratory testing (quantitative). Physicians should screen all diabetics for albuminuria and strongly consider screening hypertensives to identify those at higher risk for cardiovascular disease. Appropriate intervention, including use of drugs that block the renin-angiotensin-aldosterone system, may be appropriate in such cases as suggested by the American Diabetes Association and the Seventh Report of Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.