What Is Albumin?
Albumin is a protein that our liver produces and lets into our blood circulation. This protein is essential for our body for various functions like carrying and transporting hormones, drugs, vitamins, minerals, preventing the leakage of the fluid part of the blood from the blood vessels, and tissue repair, growth, and healing.
What Is Albuminuria?
Albuminuria is the medical terminology for the presence of excessive amounts of albumin in the urine. In normal health conditions, albumin is present in the urine in very low quantities (less than 30 mg). Our kidney filters the blood to remove all the toxins. But when the kidneys are damaged, they start letting out or leaking proteins like albumin along with other waste products through our urine.
Is Albuminuria a Serious Condition?
Excretion of high levels of albumin in the urine is not a good thing. It means the kidneys are not functioning properly or are damaged. The filters of the kidney are impaired. The cause for damaged kidneys can be kidney disease or kidney damage due to other long-standing medical conditions requiring medical treatment.
What Is the Significance of Urine Albumin?
Measuring urine albumin is crucial for two main purposes: identifying kidney disease and tracking its progression. Healthcare professionals routinely screen individuals for albuminuria during regular check-ups and closely monitor urine albumin levels in those diagnosed with kidney disease.
If the level of urine albumin remains stable or decreases, it indicates that treatments are effective. Lowering urine albumin levels through treatment may reduce the likelihood of kidney disease progressing to kidney failure. Individuals with diabetes, high blood pressure, heart disease, or a family history of kidney failure are at risk of kidney problems. Consult a doctor to determine how frequently one should undergo urine albumin testing.
What Symptoms Does Albuminuria Cause?
In some instances, albuminuria does not present with any symptoms. If present, its most common symptom remains to be a change in the appearance of the urine. The urine appears to be frothy or foamy.
Also, excessive excretion of albumin leads to a drop in serum albumin levels. Reduced albumin levels in the blood cause the fluid part of the blood to escape out or leak through the blood vessels into the tissue spaces. This fluid accumulation results in swelling around the eyes, face, feet, and hands.
What Conditions Cause High Albumin Levels in the Urine?
Kidney Diseases That Cause Increased Urine Albumin Levels:
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Kidney infection.
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Nephrotic syndrome.
Long-Standing Conditions Causing Increased Urine Albumin Levels:
Other Causes:
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Family history of kidney disease.
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Aging.
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Certain races like Africans, Americans, American Indians, Asians, and Hispanics.
Causes for the Transient Increase In Urine Albumin Levels:
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Heavy physical activity.
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Not drinking an adequate quantity of water.
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Infection.
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Posture changes.
These temporarily increased albumin levels decrease with cessation of physical activity, resolution of fever, and drinking enough water.
What Tests Reveal Albuminuria?
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Dipstick Method: This method was traditionally used to detect urine albumin levels. It uses a dipstick with a color-sensitive pad that changes its color based on albumin levels when dipped inside the collected urine. But these tests are not found to detect the minute amount of albumin present in microalbuminuria.
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24-Hour Urine Test: In this method, except for the first urine of the day, the whole day’s urine is collected and tested for albumin levels.
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ACR (Albumin-Creatinine Ratio) Test: In this test, the first-morning urine sample is taken, and the albumin-creatinine ratio (ACR) is calculated. This is the first void sample. In case of difficulties obtaining the morning sample, the urine sample is checked for ACR at the time of testing. This is known as a spot random sample.
All these tests require you to urinate some urine into a bottle or container provided by the laboratories. Additional tests may be suggested if one’s urine albumin-creatinine ratio (ACR) is significantly higher than the target range. These tests aim to provide more insights into the underlying causes of your albuminuria and may involve:
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Kidney Biopsy: This procedure is particularly recommended if there are suspicions of glomerular disease. A kidney biopsy helps determine the cause of kidney disease and assesses the extent of kidney damage.
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Imaging tests: Especially considered if there are concerns regarding kidney cancer, kidney stones, or structural abnormalities within the kidney. These tests, such as ultrasound or CT scans, generate images of kidneys and urinary tract to further investigate potential issues.
What Levels of Urine Albumin Are Of Concern?
A normal urine albumin level is usually less than 30 mg per day. In some cases, the levels of albumin are calculated in association with creatinine levels. It is known as the urine albumin-creatinine ratio (UACR). A 24-hour urine sample is obtained, and the values are calculated. Calculating albumin levels from the first urine of the day is another way. The normal and abnormal values are tabulated below:
What Do Micro and Macroalbuminuria Mean?
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Microalbuminuria-It is the persistent presence or excretion of abnormal but small amounts of urine albumin. Microalbuminuria is a cardiovascular risk indicator.
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Macroalbuminuria- Excretion of excessive amounts of urine albumin is macroalbuminuria. It indicates established kidney disease. Such high levels of excretion occur in people with long-standing diabetes.
Also, since albumin levels may vary, to confirm albuminuria, three readings must be obtained within three months. Persistent elevation in these readings confirms albuminuria.
How to Get Rid Of Excess Urine Albumin?
Albuminuria due to diabetes or high blood pressure necessitates the treatment of these conditions in the first place. Drug groups like ACE inhibitors (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers) are found to manage albuminuria and high blood pressure. Diuretic medications are given to reduce swelling due to fluid accumulation. In severe kidney disease or failure, dialysis or kidney transplants might be performed.
Does Albuminuria Cause Complications?
As increased urine albumin levels indicate underlying chronic kidney disease and other disorders, failure to treat them may ultimately lead to kidney failure. Apart from this, a recent research has yielded the fact that microalbuminuria is a certain risk marker for cardiovascular diseases both in people with and without comorbid conditions. Heart diseases with a high risk of mortality can be predicted in people with elevated urine albumin levels.
Another complication is a shorter lifespan (early death). The likelihood of experiencing these problems is closely linked to one's UACR (urine albumin-creatinine ratio) level. This means that having a higher UACR level increases the chances of developing one or more of these issues. Lowering urine ACR levels can reduce the risk of complications, even if it does not reach the desired target range.
How Can I Prevent Albuminuria?
People with a family history of kidney disease should be vigilant enough by maintaining a healthy weight and avoiding harmful habits like smoking and alcoholism to prevent future albuminuria. People with diabetes and high blood pressure need to keep their pressure and sugar values within limits by taking appropriate medicines as their uncontrolled levels tend to damage the kidney. Lifestyle modification for both people with and without comorbid conditions is necessary. Drinking adequate water and avoiding foods rich in sodium and salt is good for the kidney. Taking precautions to maintain heart health is vital.
Conclusion:
Individuals with microalbuminuria must be cautious enough to improve their cardiovascular health. People with high blood sugar and pressure levels are advised to get checked for urine albumin levels routinely. Since symptoms caused by albuminuria occur in the advanced stages, frequent monitoring of urine albumin levels may help manage the condition effectively with good treatment outcomes.
