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Random Urine Albumin-to-Creatinine Ratio Accurately Identifies Microalbuminuria

The ratio of albumin to creatinine in random urine samples can be used to identify pregnant women with type 1 diabetes who have microalbuminuria. Dr. Elisabeth R. Mathiesen from University Hospital of Copenhagen, Denmark, states that "Screening for the presence of microalbuminuria in early pregnancy is of uppermost importance since early antihypertensive treatment during pregnancy might reduce the prevalence of preeclampsia and preterm delivery in these woman with a high risk of complications."

Dr. Mathiesen and her colleagues investigated whether measurement of the albumin-to-creatinine ratio in random urine samples could replace 24-hour urine collection in screening for micro- and macroalbuminuria in 119 pregnant women with type 1 diabetes.

There was an 80% correlation between the 24-hour urinary albumin excretion and the albumin-to-creatinine ratio in random urine samples, the authors report.

Fifteen of 16 women with an albumin excretion above 30 mg per 24 hours had an albumin-to-creatinine ratio above 2.5 mg/mmol, the results indicate, and all nine women with macroalbuminuria (albumin excretion >300 mg/24 hours) had an albumin-to-creatinine ratio above 25 mg/mmol.

In contrast, the researchers note, all 103 women with an albumin excretion below 30 mg in 24 hours had an albumin-to-creatinine ratio below 2.5 mg/mmol

While 24-hour urine samples are the gold standard for detection of microalbuminuria, Dr. Mathiesen said, "The data from this paper makes it possible to use the much easier albumin-to-creatinine ratio in a random urine sample early in pregnancy."
Diabetes Care 2006;29:924-925.

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