微量白蛋白尿(microalbuminuria)是用來描述白蛋白尿水平適度增加的醫學術語。它發生在腎洩漏少量白蛋白(Human serum albumin)進入尿液裡、換言之，即在腎臟腎小球的白蛋白有異常高的滲透性(Vascular permeability)。這個醫學術語"微量白蛋白尿"現在KDIGO(Kidney Disease Improving Global Outcomes/腎臟病改善全球成果)計劃不建議使用，並以"中度增加白蛋白尿"取代之。
病因
- 血管內皮功能障礙(endothelial dysfunction)的標誌。
- 腎臟疾病預後的重要標誌：
診斷
微量白蛋白尿定義
|
個人 |
底限 |
高限 |
單位
|
| 24小時尿液收集
|
|
30 |
300 |
mg/24h (每24小時的毫克白蛋白)
|
| 短時間尿液收集
|
|
20 |
200 |
µg/min (每分鐘的微克白蛋白)
|
| 定點白蛋白尿樣本
|
|
30 |
300 |
mg/L (每公升尿液的毫克白蛋白)
|
| 定點白蛋白尿/肌酸酐比值
|
女人 |
3.5 |
25 or 35 |
mg/mmol (每摩爾肌酸酐的毫克白蛋白)
|
| 30 |
400 |
μg/mg (每毫克肌酸酐的毫克白蛋白)
|
| 男人 |
2.5 or 3.5 |
25 or 35 |
mg/mmol
|
| 30 |
300 |
μg/mg
|
參見
註釋
參考文獻
-
Abid O, Sun Q, Sugimoto K, Mercan D, Vincent JL. Predictive value of microalbuminuria in medical ICU patients: results of a pilot study. Chest. 2001, 120 (6): 1984–8. PMID 11742932. doi:10.1378/chest.120.6.1984.
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Andersen S, Blouch K, Bialek J, Deckert M, Parving HH, Myers BD. Glomerular permselectivity in early stages of overt diabetic nephropathy. Kidney Int. 2000, 58 (5): 2129–37. PMID 11044234. doi:10.1111/j.1523-1755.2000.00386.x.
-
Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet. 2000, 355 (9200): 253–9. PMID 10675071. doi:10.1016/S0140-6736(99)12323-7.
-
Lemley KV; Abdullah I; Myers BD; et al. Evolution of incipient nephropathy in type 2 diabetes mellitus. Kidney Int. 2000, 58 (3): 1228–37. PMID 10972685. doi:10.1046/j.1523-1755.2000.00223.x.
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Lièvre M; Marre M; Chatellier G; et al. The non-insulin-dependent diabetes, hypertension, microalbuminuria or proteinuria, cardiovascular events, and ramipril (DIABHYCAR) study: design, organization, and patient recruitment. DIABHYCAR Study Group. Controlled Clinical Trials. 2000, 21 (4): 383–96. PMID 10913814. doi:10.1016/S0197-2456(00)00060-X.
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Parving HH, Lehnert H, Bröchner-Mortensen J, Gomis R, Andersen S, Arner P. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N. Engl. J. Med. 2001, 345 (12): 870–8. PMID 11565519. doi:10.1056/NEJMoa011489.
- Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney inter., Suppl. 2013; 3: 1-150.
外部連結
