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Diabetes Q&A | Type 1 | Hi, Please advise me on the MALB/CREAT/
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08/25/09 10:08 AM

"Hi, Please advise me on the MALB/CREAT/RATIO PANEL. My doctor did not discuss with me on the results and the result concerns me "
Asked By: nair.ramya  
Category: Type 1

Background Info Hide
"Diabetes was detected in Feb 2008. Insulin started in April 2009 since HbA1c was high as 10.5. No Medications till April 2009. Following are my blood test results in Aug 2009. I'm on Humlog 75/25(15 Units before breakfast and before dinner). I'm not on any other medication. Does my MALB/CREAT/RATIO PANEL show Kidney problems? Should I go back to check with my doctor. I have my next appointment in Sept 2009. Please advise. Random Blood Sugar 81mg/dl HbA1c 6.9 Serum creatinine 0.8 Cholesterol 161 TSH 2.4 Thyroglobulin AB 2210 Thyroid Peroxidase AB >1000 GAD Auto ABS 74 Free Thyroxine 0.74 MALB/CREAT/RATIO PANEL Creatinine Urine, Random 583mg/L MicroAlbumin, Urine 29.9 MALB/CREAT/RATIO 513

Expert Answers (1)

10/20/09 02:35 PM

Hello Nair.Ramya: Thanks for asking dLife, good job in taking control with the A1c, BS, Tcholesterol, and yes, having diabetes can make your kidneys unhealthy. As you most likely are familiar, the kidneys function as our filter for toxins, metabolic waste products and maintain healthy electrolyte levels. Healthy kidneys process approximately 200 quarts of blood daily and remove approximately 2 quarts of water and waste products which are then excreted from the body as urine. Urea and creatinine, nitrogen-containing metabolic waste products derived from the digestion of dietary protein and from muscle activity, are filtered out of the bloodstream and excreted by the kidneys. Assessing kidney functions are done via the microalbuminuria, or a measure of the albumin-to-creatinine ration in a spot urine collection, as you had. When the kidneys are damaged the first signs are to leak, what is leaked is a protein called albumin, resulting in a low protein level in the blood. The job of albumin is to hold water and maintain a normal health status.

Urine tests and blood tests to detect the progress of kidney disease include: Blood urea nitrogen and serum creatinine, and creatinine clearance, as to indicate how the kidneys are processing waste.
Interpretation, (I would encourage you to have a sit down with your doctor to completely discuss and identify actions you can take), of the results they may be the presence of 'clinical albuminuria' (greater than or equal to 300ug/mg). Due to the variability in urinary albumin excretion, at least 2-3 measures are done within a 6 month period to adequately evaluate.

Bases on the numbers you report, albumin-to-creatinine ratio of 513, suggest that a 24 hour urine test is also indicated in order to quantify the protein excretion and establish a glomular filtration rate or GFR.To slow any more damage:

  • keep the BG tightly controlled
  • BP under control
  • limit salt
  • limit proteins. Be your best. Regards Sue
    • Answered By: Susan Throop
    Accreditations: RD, CDE, MA
    Sources Show

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