MONITORING KIDNEY FUNCTION
Screening for kidney disease is very important because there are treatments that prevent the
kidney disease from getting worse . The screening usually starts five years after diagnosis in people with type
1 diabetes, and at diagnosis in people with type 2 diabetes. Doctors recommends that people with diabetes
be screened annually for kidney disease by measuring blood creatinine levels and urine albumin level in the first
morning urine.It is not necessary to do a twenty-four-hour or an overnight urine collection: the spot urine first
thing in the morning is just as good. Your doctor will give you a small urine cup, and you will collect the first
morning urine and take it to the lab. A urine albumin of less than 30 (milligrams per gram creatinine) is
normal, 30 to 300 indicates early diabetic kidney disease (microalbuminuria), and greater than 300 indicates
more signifi cant disease (macroalbuminuria).
The urine albumin test is affected by posture and physical activity, and it is important to
collect the first morning urine immediately after you get up. Fever and uncontrolled diabetes with very high
glucose levels can also falsely raise the urine albumin excretion, and so you should wait until these problems
have resolved before doing the test. If there is a marginal elevation in the urine albumin excretion, your
doctor will measure it again within the next six months.
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