MICROALBUMINURIA AND DIABETES-MELLITUS

Small concentrations of albumin detected in the urine predict renal dy sfunction and reflect vascular abnormalities such as atherosclerosis, retinopathy and, probably, neuropathy. Although microalbuminuria is no t specific for diabetic complications, it has been most extensively st udied in diabetics. The rate of urinary albumin excretion can also be used to determine therapeutic response to pharmacologic and lifestyle interventions such as diet, smoking cessation and physical activity. T he pathophysiology of microalbuminuria and its clinical significance i n diabetes is presented, along with a discussion of measurement issues and implications for clinical management. An algorithm for the evalua tion of diabetic patients is included.