Dear All
We now have the technical capacity to cope with our
request workload for microalbumin, and are in the
process of introducing the albumin:creatinine ratio as
a screening test. From the literature, there seems to
be little consensus over reference values. Mike Mead
in Br J Diab & Vac Dis May/June 20022002;2:191-4
states that "microalbuminuria is usually defined as a
urinary albumin: creatinine ratio (ACR) of >2.5
mg/mmol in men and >3.5 mg/mmol in women." However, in
the CALM Study (Mogensen et al, BMJ
2000;321:1440-1444) 2.5 was used as the cutoff in both
sexes.
Others I know use > 2 in men and >3.3 in
women.Official guidance in the UK makes little or no
mention of the screening test.
Who is right? There are huge implications for the
numbers of timed urine collections we might have to do
dependent on the screening cutoffs used.
Dr Lance N Sandle BSc MBChB FRCPath
Consultant Chemical Pathologist/Associate Medical
Director
Trafford General Hospital
Moorside Road
Davyhulme
Manchester M41 5SL
(T) 0161 746 2473
(F) 0161 746 8545
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