Laboratory standard—upper limit of normal range for microalbumin, total milligrams per litre N[NN].N
Identifying and definitional attributes
|Metadata item type:||Data Element|
|Short name:||Upper limit of normal range for microalbumin (milligrams per litre)|
The laboratory standard for the value of microalbumin that is the upper boundary of the normal reference range, measured in milligrams per litre (mg/L).
|Data Element Concept:||Laboratory standard—upper limit of normal range for microalbumin|
Value domain attributes
|Maximum character length:||4|
|Unit of measure:||Milligram per litre (mg/L)|
|Unit of measure precision:||1|
Data element attributes
Collection and usage attributes
|Guide for use:|
Record the upper limit of the microalbumin normal reference range for the laboratory.
Measurement of microalbumin levels should be carried out by laboratories, or practices, which have been accredited to perform these tests by the National Association of Testing Authorities (NATA).
Microalbumin is not detected by reagent strips for urinary proteins, and requires immunoassay.
Excessive amounts of microalbumin (microalbuminuria) in the urine are a key marker of kidney damage and of increased renal and cardiovascular disease risk.
Timed urine collections are considered the gold standard for evaluating microalbuminuria, but are logistically difficult. In routine clinical practice, 24-hour collections are inconvenient to patients and are subject to significant inaccuracies due to incomplete collection of all urine voided, timing errors and appreciable intra-individual variation due to varying activity, hydration and diet.
The preferred method for assessment of microalbuminuria in both diabetic and non-diabetic individuals is urinary albumin/creatinine ratio (ACR) measurement in a first-void (first morning) spot specimen. Where a first-void specimen is not possible or practical, a random spot urine specimen for ACR is acceptable. A positive ACR test should be repeated to confirm persistence of microalbuminuria. Chronic kidney disease is present if 2 out of 3 tests (including the initial test) are positive. If the first positive urine ACR is a random spot test (as it may be for opportunistic testing), then repeat tests should ideally be first morning void specimens.
Kidney damage stage is categorised into 3 stages based on a spot urine collection. The upper limit of normal range for microalbumin is the maximum value for normoalbuminuria.
Source and reference attributes
Australian Institute of Health and Welfare (AIHW)
Kidney Health Australia (KHA) 2012. Caring for Australians with Renal Impairment (CARI) Guidelines. Diagnosis, classification and staging of chronic kidney disease. Sydney: KHA . Viewed 20 October 2015, http://www.cari.org.au/CKD
|Related metadata references:|
Supersedes Laboratory standard—upper limit of normal range for microalbumin, total milligrams per litre N[NN].N
See also Person—microalbumin level, total milligrams per litre N[NNN].N
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