Most diabetic patients are put on ACEI/ARA (to bring
BP to target of < 120/80)and on statin (to bring LDL
to < 3.0 mmo/L or < 2.5 mmol/L)and ofcourse on
aspirin. Therefore knowing microalbumin result will
have no added value in altering therapeutic
intervention in the majority.
Mohammad
--- Martin Holland <[log in to unmask]>
wrote: > You may not need to measure microalbumin at
all in
> diabetic patients. In a
> study we did (yet to be published), using any one of
> 4 clinical risk models,
> you would miss less than 4% of patients with an ACR
> > 10. The models
> included antihypertensive status, systolic BP and
> dipstick protein. The
> models ranged from:-
> 1. on antihypertensive agents and systolic BP > 160
> mmHg and dipstick
> protein =2+, ACR > 10 missed = 4%
> 2. on antihypertensive agents and systolic BP > 140
> mmHg and dipstick
> protein =1+, ACR > 10 missed = 1%
>
> And microalbumin screening would not have triggered
> intervention over and
> above the clinical strategy in 60-80% of the
> population.
>
> Regards,
>
> Martin.
>
> Dr M R Holland
> Dept Clinical Chemistry
> New Cross Hospital
> Wolverhampton.
>
>
> -----Original Message-----
> From: Fiona Bethell
> [mailto:[log in to unmask]]
> Sent: 24 July 2003 17:39
> To: [log in to unmask]
> Subject: Re: Microalbumin
>
>
> I have been asked by a practice nurse this week how
> to measure microalbumin
> in the surgery so I have arranged to borrow
> analysers from HemoCue and a
> Quikread from Biostat. There is also another POCT
> analyser marketed by Axis
> Shield (see web page) but the method seemed to have
> several diltuion and
> pipetting steps. The cost will obviously be more
> than using micral
> dipsticks (Roche) or microalbustix (Bayer) but the
> analysers give
> quantitative results. I haven't actually started the
> lab comparisons with
> our method (Wako reagent run on the Roche P Module)
> but interested parties
> could contact me later!
>
> Dr Fiona Ivison
> Dept. of Clinical Chemistry
> Royal Liverpool University Hospital
> 4th Floor Duncan Building
> Liverpool
> L7 8XP
>
> 0151 706 4287
>
>
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=====
Dr. M A Al-Jubouri
Consultant Chemical Pathologist
________________________________________________________________________
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