Microalbuminuria: monitoring and management
This series is aimed at helping the busy GP diagnose and manage patients with diabetes and its complications. How would you confirm that this patient has microalbuminuria, and what are the implications of this finding?
Case history
As part of the monitoring of diabetes, you check your patient, Lisa, for microalbuminuria. Her spot urine albumin level is 70 mg/L.
Lisa is 63 years old and has had moderately controlled type 2 diabetes for 12 years (HbA1c 7 to 9%). She has hypertension that is being treated (current blood pressure is 130–145/80–90 mmHg), and her recently measured lipid profile is: total cholesterol 5.7 mmol/L, LDL cholesterol 4.0 mmol/L, triglyceride 1.8 mmol/L, HDL cholesterol 0.8 mmol/L. She is slightly overweight (height 154 cm, weight 61 kg) but walks briskly for 30 to 40 minutes every day. She has never smoked and has one to two drinks per week.