My 83 yr old mom had liver health issues after working for more than 18 years as a caregiver for bay area seniors. With yellowing skin, itchy and so fragile, we use holistic means to promote wellness while she finished her antibiotics.
We had a former senior with kidney issues that loves our foot massage. Liver and kidneys do well with foot massage. Our caregiving service includes massage, hugs and gourmet healthy meals.
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Dr. Henderson is interviewed by New York City naturopathic doctor, Jared Hanson.
Q: This is the first of what I hope will be many in a series of interviews with experts in natural or alternative medicine. Dr. Jenna Henderson N.D. is a naturopathic physician and an expert in the holistic approach to kidney health. Information on natural approaches to kidney disease is incredibly valuable and unfortunately it can be hard to find.
What role do you think natural medicine should play in the treatment of kidney disease?
Dr. Jenna C. Henderson: Having seen natural medicine and mainstream medicine close up in dealing with kidney disease, I think there is a lot the natural medicine can offer patients that they can’t find anywhere else. For those in an early stage of kidney disease, we can bring their bodies back into balance. And for those in a later stage with severely compromised kidneys, we can keep their kidney function going with a maintenance regimen. Natural medicine has the tools to control blood pressure, inflammation and cholesterol and improve kidney function– and all of it without the dangerous side effects of prescription drugs.
Q: So let’s look at someone in an early stage, if they’ve just been diagnosed with kidney disease. Are there specific steps that you would recommend?
Dr. Jenna C. Henderson: In the early stage of kidney disease there is some damage to the nephrons or filtering units, but the kidneys are still able to clean the blood thoroughly. As long as the creatinine is under 1.3 your function is still pretty good.
First get to the bottom of what’s causing the kidney damage. If it’s diabetes, get it under control. If it’s hypertension, control that. If it is one of the inflammatory kidney diseases such as IgA nephropathy, Focal Sclerosis or Minimal Changec– bring down the inflammation.
For the Type 2 diabetic change their lifestyle and lose weight. The addition of some supplements for glycemic control can help too.
With high blood pressure it is important to take medications on a regular basis. Even one skipped dose can be damaging. Of course, I prefer a natural approach with stress management and botanicals. The prescription drugs can cause erectile dysfunction in males and a loss of desire in females. Many of them will weaken the heart over time.
When the kidneys are inflamed there is a loss of protein in the urine. The urine looks foamy when this happens. It is easy to know if what you’re doing to reduce inflammation is working because the urine will be less visibly foamy. Adopt a diet that has many fresh fruits and vegetables and avoid saturated fat and fried foods. Natural anti-inflammatories will make a world of difference – quercetin, bromelain and fish oil will make the urine visibly less foamy.
And from the Eastern perspective do the things that preserve kidney chi and bring you into balance. Get plenty of sleep – at night. This is especially important but hard as many kidney patients deal with insomnia and they are awake all night and sleep during the day. Acupuncture can help and sunlight during the morning hours can reset the body’s internal time clock.
Q: How do the recommendations change for those with more advanced disease, such as patients who are already on dialysis?
Dr. Jenna C. Henderson: Well it’s my hope to prevent their going on dialysis. With advanced disease I would add on to their protocol with high dose coenzyme Q10 and l-carnitine. When the kidneys have sustained damage there is a loss of functioning nephrons to filter the blood. That means that the remaining nephrons have to work harder to keep up with the body’s demands. That is called a state of hyper-filtration, when the kidneys are overworked. That is when they are most vulnerable to fail. The purpose of the coenzyme Q10 and l-carnitine is to supply energy on the cellular level to the nephrons. This will support the remaining nephrons in keeping up with the body’s demands. This approach can keep dialysis at bay for a long time, sometimes indefinitely.
If you have had diabetes, high blood pressure or nephritis for any length of time, you can bet there has been damage and your kidneys are in a state of hyper-filtration. Even if your creatinine is normal. Your kidneys are working harder and harder to keep the blood clean. When the creatinine jumps up it happens suddenly. It’s like your gas tank going from full to zero all at once, but that is how chronic kidney failure happens. It is a chronic situation that all of a sudden becomes a crisis.
When you’re on dialysis it seems like the end of the world but there are many things you can do to keep your body in optimum shape. Keep up the coenzyme Q10 and add solid hawthorne extract to protect the heart. People don’t die from uremic poisoning in this day and age, but they do die from heart failure as a complication of the kidney disease process. Also, green tea to lower the BUN and bioflavonoids to strengthen the blood vessels. If you do hemodialysis it is very hard on the blood vessels. The bioflavonoids are very important. Also eat lots of berries – safe for the dialysis diet and rich in bioflavonoids.
The dialysis diet is very restrictive, but it is important to stick with it. That means that there are a lot of nutrients in fresh fruits and vegetables that are off limits to a dialysis patient because they are high in potassium. When the kidneys fail they no longer filter out potassium and elevated levels could stop the heart. Don’t cheat on this diet, but try to make up the nutrients you are missing with supplements.
Q: When you say dialysis can be kept at bay, do you feel that there are people who are put on dialysis too early when a natural approach would be more appropriate? In your opinion, is there a possibility to come off dialysis in certain patients?
Dr. Jenna C. Henderson: No. When it’s time to go on dialysis, don’t fight it. There are some people who will use extreme protein deprivation and can delay it to some extent, but when it’s time to get on the machine, do it. There are no natural approaches that I’m aware of, and I’ve been looking at this for 15 years, that can help at that point. When the kidney function is gone or you’re left with residual function which is not enough to sustain life, it is time to get on the machine. At that point we look at natural remedies for maintaining optimum wellness.
Q: Do you have any preventative advice for the general public for protecting their kidney function? Are there any hidden threats to kidney function that you think people need to be more aware of?
Dr. Jenna C. Henderson: The most common reason people experience kidney failure is diabetes and second is high blood pressure. Early screening and consistent care can be helpful in most situations.
As far as kidney diseases that involve the immune system I believe that sunlight and Vitamin D are very important. Vitamin D plays a critical role in the function of the immune system. And these diseases are more prevalent in places with less sunlight exposure.
African Americans have these kidney problems frequently but Africans generally do not. In Northern Europe, these conditions are relatively common but in Australia it is much less so. It is a similar worldwide distribution to Multiple sclerosis – another autoimmune disease, being common where there is less sunlight. Since people in the last century have moved indoors and no longer work outside we have seen an explosion of autoimmune diseases.
So one of the best things you can do is get your kids away from the computer and doing something physical outside.
By Dr. Mercola
Your kidneys — two bean-shaped organs — are located just below your rib cage one on either side of your spine. Positioned on top of each kidney are your adrenal glands. Each day, your kidneys filter up to 150 quarts of blood and flush out waste products through your urine.
One of the reasons why you need to drink enough water is to ensure healthy kidney function. In fact, chronic low-grade dehydration is one of the most common causes of kidney stones.
Poor kidney function is also associated with a number of other serious health problems, including diabetes, hypertension, and heart disease. Common signs of kidney problems include:
Good kidney function1 is essential for maintaining homeostasis in your body, starting with the composition of your blood. For example, your kidneys are responsible for maintaining proper pH level and electrolyte balance (the ratios of sodium, potassium and phosphates).
They also produce hormones that make red blood cells, and those that help regulate your blood pressure.
Waste products removed by your kidneys and eliminated through your urine include urea and uric acid, produced from the breakdown of proteins and nucleic acids respectively.
Excessive protein intake increases urea, while uric acid is a byproduct of both protein and fructose metabolism. Fructose typically increases uric acid within minutes of ingestion.
I became fully aware of the dramatic and devastating impact fructose has on your uric acid levels when I interviewed Dr. Richard Johnson on this topic.
Most Americans consume three to five times more protein than they need, and two to four times (or more) fructose than is considered safe. These two dietary factors, alone and especially in combination, places significant stress on your kidneys and promote kidney disease and kidney stones.
Kidney stones are particularly linked to a diet high in processed fructose and other sugars, as sugar upsets the mineral relationships in your body by interfering with calcium and magnesium absorption. The phosphorus acid in soda also acidifies your urine, which promotes stone formation.
Analgesic drugs are also known to damage your kidneys when taken in excess, and/or over long periods of time. This includes aspirin, anti-inflammatory drugs (NSAIDs), ibuprofen, naproxen, and acetaminophen — especially when taken in combination with alcohol, even if the amount of alcohol is small.
Research2,3 shows that combining alcohol with acetaminophen raises your risk of kidney damage by 123 percent, compared to taking either of them individually. Long term alcohol consumption and smoking also take their toll on kidney function.
To protect your kidney function, keep the following three basic factors in mind:
•Restrict protein to just what your body needs. An ideal protein intake is likely around one-half gram of protein per pound of lean body mass, which for most is 40 to 70 grams a day.
The American Kidney Fund recommends restricting protein to a maximum of 50 grams if you have kidney disease4
•Restrict fructose to 25 grams per day (about 6 teaspoons), or less (especially if you’re insulin/leptin resistant)
•Drink pure, clean water. Simply swapping out sweetened beverages like sodas and fruit juices for pure water can go a long way toward improving your kidney function and overall health.
The best way to gauge your water needs is to observe the color of your urine (it should be light pale yellow) and the frequency of your bathroom visits (ideally, this is around seven to eight times per day).
Considering the fact that the majority of Americans are overweight or obese, I recommend calculating your individual protein requirement based on lean bodyweight (your total weight minus your fat) only.
For optimal health, I believe most adults need about 1 gram of protein per kilogram of lean body mass (not total body weight), or 0.5 gram of protein per pound of lean body mass.
In this formula, you must first determine your lean body mass. To do that, subtract your percent body fat from 100. For example, if you have 30 percent body fat, then you have 70 percent lean body mass.
Then multiply that percentage (in this case, 0.7) by your current weight to get your lean body mass in pounds or kilos. As an example, if you weigh 170 pounds; 0.7 multiplied by 170 equals 119 pounds of lean body mass.
Using the “0.5 gram of protein” rule, you would need 59.5 or just under 60 grams of protein per day.
100 – % of body fat = % of lean mass X actual weight X 0.5 gm protein = total grams of protein recommended
Example: A 170 lb individual with 30% fat mass
100% total weight – 30% fat mass = 70 % lean mass
0.70 X 170 = 119 X 0.5 = 60 grams of protein recommended
To determine whether you’re getting too much protein, simply calculate your lean body mass as described above, then write down everything you’re eating for a few days, and calculate the amount of daily protein from all sources.
Again, you’re aiming for one-half gram of protein per pound of lean body mass, which would place most people in the range of 40 to 70 grams of protein per day. If you’re currently averaging a lot more than that, adjust downward accordingly.
The chart below can give you a general idea of the protein content of many foods. I personally use Cronometer.com to enter everything I eat and carefully calculate my protein requirement to the gram.
Just be sure to enter the correct foods and amounts into the program, as the results will be inaccurate if you don’t enter the correct details.
| Red meat, pork, and poultry average 6 to 9 grams of protein per ounce.
An ideal amount for most people would be a 3-ounce serving of meat (not 9 or 12 ounce steaks!), which will provide about 18 to 27 grams of protein |
Eggs contain about 6 to 8 grams of protein per egg.
So an omelet made from two eggs would give you about 12 to 16 grams of protein. If you add cheese, you need to calculate that protein in as well (check the label of your cheese) |
| Seeds and nuts contain on average 4 to 8 grams of protein per quarter cup | Cooked beans average about 7 to 8 grams per half cup |
| Cooked grains average about 5 to 7 grams per cup | Most vegetables contain about 1 to 2 grams of protein per ounce |
Interestingly, while fish is typically considered a good source of protein, most fish contain only HALF of the protein found in beef and chicken. The reduced protein content in fish may actually be one reason why the Mediterranean diet is linked to life extension and reduced risk for chronic disease.5 In essence, those who eat more fish than red meat are automatically getting far less protein.
If you have kidney disease, you also need to reduce consumption of foods rich in phosphorous, as they may promote the formation of kidney stones. On the other hand, if you have problems urinating but don’t yet have kidney disease, try adding more potassium-rich foods (primarily vegetables and seeds) to your diet. Depending on the type of kidney stone you have, you may also need to modify your diet in other ways:
•Struvite stones: Found more often in women, these are almost always the result of urinary tract infections
•Cystine stones: Represent a very small percentage of kidney stones. These are the result of a hereditary disorder that causes your kidneys to excrete massive amounts of certain amino acids (cystinuria)
•Uric acid stones: These are a byproduct of protein and fructose metabolism, and are commonly seen with gout. Cutting your protein and fructose consumption is essential for preventing and treating these types of stones. Taking potassium citrate (which lowers urine acidity and reduces urine excretion of calcium) may also help prevent uric acid stones6
•Calcium oxalate stones:7 These are the most common. About 80 percent of kidney stones are calcium based, and about 80 percent of those are calcium oxalate stones. Typically, they are the result of insufficient water intake and dietary factors, including excessive oxalate, protein, and processed salt consumption
Oxalate is found in some fruits and vegetables, but your liver produces most of your oxalate. If you are found to have oxalate stones, your physician may recommend avoiding oxalate-rich foods. Also, make sure you’re getting enough magnesium, as magnesium helps prevent calcium from combining with oxalate to form stones8
If you have calcium oxalate stones, rather than reducing your calcium intake you’ll want to minimize the amount of oxalates in your body. Soy and beer are two primary culprits that should be avoided. For reasons that are unclear, grapefruit juice has been shown to increase the risk of kidney stones9 and is therefore best avoided. Other foods that contain high levels of oxalate10 that you’ll want toavoid if you have calcium oxalate kidney stones include:
| Spinach | Rhubarb | Chocolate |
| Parsley | Beetroot | Most legumes,11 including green beans |
| Wheat and other grain-based flours12 | Pepper | Nuts13 |
Potassium is a nutrient that receives a great deal of attention when you have kidney disease. On the one hand, potassium (a mineral and electrolyte) is essential for your cells, tissues, and organs to function properly. It plays a vital role in heart health, digestive, and muscular function, bone health, and more.
While potassium is found in many foods commonly consumed in the U.S. — including fruits, vegetables, dairy products, salmon, sardines, and nuts — only 2 percent of U.S. adults get the recommended daily amount of 4,700 milligrams (mg).
This can be problematic because potassium needs to be kept in proper balance with sodium in your blood. If you consume too much sodium, which is common if you eat many processed foods, you’ll have an increased need for potassium. Others who are at particular risk of low potassium (hypokalemia) are those with chronic malabsorption syndromes, such as Crohn’s disease, or those taking heart medicine (particularly loop diuretics).
However, anyone who eats a poor diet — an excess of processed foods and not enough fresh, whole foods — is potentially at risk of inadequate potassium levels.
All of that said, if you have severe kidney impairment, you typically need to restrict your intake of high-potassium foods.14 Why? Because your kidneys are responsible for maintaining the proper amount of potassium in your body, and when they’re not working well, your levels could become excessively elevated.
Potassium helps maintain a regular heart rhythm and plays a role in muscle function, and when your potassium level gets too high, it can lead to irregular heartbeat and/or a heart attack.
If your kidneys are working well, the recommended amount of potassium is about 4,700 mg per day,15 which also needs to be balanced with sodium. As a general rule, your potassium to sodium ratio should be around 5:1. The easiest way to achieve this ratio is to eat REAL food (lots of fresh vegetables), ideally organically and locally grown to ensure optimal nutrient content.
This type of whole food diet will naturally provide much larger amounts of potassium in relation to sodium, whereas a processed food diet is virtually guaranteed to provide you with an upside-down ratio. Juicing your vegetables is a good way to ensure you’re getting enough potassium.
If you have kidney disease, you need to pay careful attention to your potassium level and dietary intake. Most who are being treated for kidney disease will monitor their potassium level by measuring it monthly, and potassium- restricted diets typically recommend keeping potassium intake to about 2,000 mg per day.
Besides monitoring your protein and sugar/fructose intake and drinking plenty of water, adding the following foods to your diet can also help promote optimal kidney function.16,17,18,19,20
| Red bell peppers: low in potassium, rich in vitamins A, B6, C, folic acid and fiber | Cherries: rich in antioxidants and phytochemicals |
| Cabbage: low in potassium, rich in vitamins C and K, and fiber, and phytochemicals that protect against free radical damage | Red and purple grapes: rich in antioxidants; the skin is particularly rich in resveratrol |
| Cauliflower: high in vitamin C, folate and fiber | Watermelon: rich in water, with diuretic properties, allowing you to produce more urine to flush out toxins |
| Garlic: antioxidant, anti-inflammatory, and anti-clotting properties | Lemon juice: helps reduce kidney stone formation |
| Onion: low in potassium, rich in antioxidants, particularly quercetin, which has natural antihistamine properties | Pumpkin seeds: rich in antioxidants, vitamins and minerals, especially magnesium, which helps reduce the risk of kidney stones |
| Apples: high in fiber, antioxidants, and anti- inflammatory compounds. Raw organic apple cider vinegar is helpful for the prevention of kidney stones | Kale: lower in potassium, good source of vitamins A and C, rich in iron — the latter of which is important for kidney health. Many with kidney disease are also iron deficient21 |
| Berries,22 including blueberries, raspberries, and strawberries | Sweet potatoes: rich in beta-carotene, vitamins A and C, and fiber, and a good source of B6 and potassium |
A number of herbs also have kidney-cleansing properties, including the following:
| Ginger: purifies the blood and kidneys of toxins | Red clover: diuretic that stimulates waste removal from the kidneys |
| Turmeric: has antiseptic and anti-inflammatory properties that help prevent and treat kidney infections and inflammation | Chanca Piedra: Used in South America to break up kidney stones (its Spanish name actually means “stone breaker”) |
| Dandelion: a natural diuretic that helps strengthen the kidneys and soothe urinary tract problems | Hydrangea root: Native American remedy for kidney stones |
| Nettle: natural diuretic that helps purify blood and treat urinary tract infections; also high in iron, making it beneficial for building blood | Uva ursi root: helps treat urinary and bladder problems |
| Marshmallow root: natural diuretic that helps treat urinary tract infections, kidney stones, and bladder infections | Gravel root (Joe-Pye weed): Indian remedy for urinary tract and kidney health |
| Juniper: improves kidney function and helps treat urinary tract infections and kidney and/or bladder stones.
Avoid juniper berry if you have a kidney infection and/or are pregnant. Also don’t take continuously for more than four weeks |
Goldenrod root: Native American remedy traditionally used to support urinary tract and kidney health |
| Yarrow root: a natural diuretic with antiseptic and anti-inflammatory properties; helpful for urinary tract infections |
Sugary snacks he cannot avoid as guests bring him foods. We massage him which helps his constipation and leg pains.
Connie
Feb 20, 2017 – A 28-study review at the University of Sao Paulo, Brazil, involving more than 1,000 patients on kidney dialysis, resulted in more very promising statistics. Scientists found that those who regularly employed both aerobic and resistance (strength) training exercises lowered their blood pressure readings …
Feb 15, 2016 – By Dr. Mercola. Your kidneys — two bean-shaped organs — are located just below your rib cage one on either side of your spine. Positioned on top of each kidney are your adrenal glands. Each day, your kidneys filter up to 150 quarts of blood and flush out waste products through your urine. One of the …
Jan 8, 2005 – About 15 percent of the people on dialysis (an artificial blood-filtering process used to clean the blood of malfunctioning kidneys) are getting this treatment as a result of the damage that Tylenol and/or aspirin did to their kidneys. So, avoiding Tylenol and aspirin will be very important to preventing kidney …
Jun 22, 2016 – If possible, performing acupuncture during this time can be very beneficial, as can several homeopathic remedies (based on your dog’s symptoms). If supportive treatment isn’t working, there may be other options, for example, dialysis or organ transplant. Decisions about more aggressive forms of treatment …
Oct 12, 2016 – Doctor’s Note. You can imagine how overwhelming NutritionFacts.org might be for someone new to the site. With videos on more than 2,000 health topics, where do you even begin? Imagine someone stumbling onto the site when the new video-of-the-day is about how some spice can be effective in …
I got stage 5 Kidney failure, eGFR 6, my Creatinine is 8.7 when measured by mg% method or 770 when measured by µmol/L method. My Urea is 37.3 measured (mmol/L). I’m not going to do dialysis, does anyone know what herbs and what exactly i should be taking from the incurable program that can get my creatinine and …
At that point, the only treatment options are dialysis or kidney transplant. Diabetes injures the kidneys by damaging the organ’s small blood vessels, depriving it of nutrients and oxygen and limiting its ability to function properly. When this happens, the body retains more water and salt than it should, causing weight gain and …
At this time, approximately 468,000 Americans are on long-term kidney dialysis. Kidney Transplant − The … Only cancer requires more visits to the doctor for treatments and procedures. This World Kidney Day take a … If both kidneys fail, you are left with two options: dialysis or kidney transplant. Transplant waiting lists are …
I used to dislike Dr. Greger. But, after watching video after video that he has produced I greatly respect him and …
For more info: https://draxe.com/kidney-cleanse/?utm_campaign=Youtube-Dec-2015&utm_medium=social …
This natural remedy will help improve your body’s pH balance, promoting better liver, pancreatic, and kidney health. Just the simple habit of drinking this mixture on an empty stomach will do wonders for your body. It improves kidney function, helping your body detox itself, and prevents problems like the accumulation of fat …
The kidneys prevent the buildup of waste in the body, keep electrolyte levels stable, and make hormones that regulate blood pressure, make blood cells, and maintain strong bones. … Both the pancreas and thekidneys will suffer a significant reduction in their ability to produce sodium bicarbonate effectively. Without …
Aug 14, 2017 – The pancreas and liver are both vital organs. If your pancreas or liver ever stopped functioning properly, your life would be in danger. Taking care of both organs through diet, exercise and limited alcohol intake will promote both organs to maintain healthy functioning. If your liver or pancreasever do stop …
Dec 15, 2015 – There’s a lot of items in your kitchen that could easily replace those kept in your medicine cabinet. Although you may already know about baking soda’s incredible uses, you’ve probably never heard of this one before: Baking soda (sodium bicarbonate) can actually help your kidneys heal and function …
Oregano has shown promise as becoming a treatment for oxidation caused disorders, such as diabetes, due to its rich, natural phenolic antioxidants. … Like haritaki and calendula, dandelion is believed to be an effective treatment against aggressive pancreatic cancer cells, and especially against those that appear to be …
This is very natural and inexpensive treatment that can help you purify your body, the kidneys, pancreas, liver and other organs. This is important to know and concerns a lot of people because it can even help saving lives! The main ingredient of this remedy is the coriander. This plant is rich with components that can help …
As a healthcare provider, I feel compelled to help these patients deal with their pain naturally and relieve the causes as best as possible. Many of these …. Acute pancreatitis is caused by toxins that induce acinar cell calcium overload, zymogen activation, cytokine release and cell death, yet is without specific drug therapy.
Jan 5, 2017 – Google searches indicate that comparatively, the pancreas is not searched as much as the heart, liver, kidneys, lungs or colon. … From there, these food particles get into our blood so that our bodies can use the food for cellular energy, building our cells, feeding our bodies with nutrients, minerals, and …
You’re not going to spend a fortune nor a lot of time making this homemaderemedy. It’s fantastic, because it …
Colon Detoxifiers Liver Detoxifiers. Kidney Detoxifiers Pancreas Detoxifiers Top 10 Natural Methods to Detox Benefits of the DTD Cleanse and Detox Program …. This is a key point to understand because if your cells can’t repair the damage being caused by your diabetes, then, it will be difficult to stabilize your blood …
When you are 40plus or having some health issues with your kidneys, it is best to get a urine test. I offer this test from LifeExtension via LabCorp. This test comes with free health coaching from me.
LC140285 – MICROALBUMIN/CREATININE RATIO,RANDOM URINE (early morn to check your kidneys) New Item $73.33
Microalbuminuria is a term to describe a moderate increase in the level of urine albumin. It occurs when the kidney leaks small amounts of albumin into the urine, in other words, when there is an abnormally high permeability for albumin in the glomerulus of the kidney. Normally the kidneys filter albumin, so if albumin is found in the urine it’s then a marker of kidney disease. The term ‘microalbuminuria’ is now discouraged by KDIGO (Kidney Disease Improving Global Outcomes) and has been replaced by ‘moderately increased albuminuria’.
Microalbuminuria is an important adverse predictor of glycemic outcomes in pre-diabetes. Pre-diabetes individuals with increased microalbuminuria even in the so-called normal range is associated with increased progression to diabetes and decreased reversal to normoglycemia. Hence prediabetes individuals with microalbuminuria warrant more aggressive intervention to prevent diabetes in them.[2]
Higher dietary intake of animal protein, animal fat, and cholesterol may increase risk for microalbuminuria,[3] and generally, diets higher in fruits, vegetables, and whole grains but lower in meat and sweets may be protective against kidney function decline.[4][5][6]
The level of albumin protein produced by microalbuminuria can be detected by special albumin-specific urine dipsticks, which have a lower detection threshold than standard urine dipsticks. A microalbumin urine test determines the presence of the albumin in urine. In a properly functioning body, albumin is not normally present in urine because it is retained in the bloodstream by the kidneys.
Microalbuminuria can be diagnosed from a 24-hour urine collection (between 30–300 mg/24 hours) or, more commonly, from elevated concentration in a spot sample (20 to 200 mg/L). Both must be measured on at least two of three measurements over a two- to three-month period.[7]
An albumin level above the upper limit values is called “macroalbuminuria”, or sometimes just albuminuria. Sometimes, the upper limit value is given as one less (such as 300 being given as 299) to mark that the higher value (here 300) is defined as macroalbuminuria.[8]
To compensate for variations in urine concentration in spot-check samples, it is helpful to compare the amount of albumin in the sample against its concentration of creatinine. This is termed the albumin/creatinine ratio (ACR)[9] and microalbuminuria is defined as ACR ≥3.5 mg/mmol (female) or ≥2.5 mg/mmol (male),[10] or, with both substances measured by mass, as an ACR between 30 and 300 µg albumin/mg creatinine.[11] For the diagnosis of microalbuminuria, care must be taken when collecting sample for the urine ACR. An early morning sample is preferred. The patient should refrain from heavy exercises 24 hours before the test. A repeat test should be done 3 to 6 months after the first positive test for microalbuminuria. Lastly, the test is inaccurate in a person with too much or too little muscle mass. This is due to the variation in creatinine level which is produced by the muscle.[12]
