Assessing albuminuria in spot morning samples from diabetic patients

Microalbuminuria assessment is essential for diagnosing incipient nephropathy in diabetic patients. The present study aim to evaluate whether urinary albumin concentration (UAC) and urinary albumin-to-creatinine ratio (UACR) agree with 24 h urine collection in screening for albuminuria > 30 mg/24 h in type 1 and 2 diabetics. In this cross-sectional study were evaluated 293 diabetic patients (117 type 1 and 176 type 2). Albuminuria was determined by turbidimetric immunoassay. The best discriminator value was 22 mg/l (sensitivity 82.5%, specificity 74.0%) for UAC and 27.3 mg/g creatinine (sensitivity 83.3%, specificity 80.9%) for UACR. Areas under ROC curves were 0.868 and 0.878, respectively (p = 0.53). Lower discriminators as 10 mg/l (sensitivity 94.2%, specificity 48.6%) and 10 mg/g creatinine (sensitivity 96.7%, specificity 49.1%) attained high sensitivities. UAC and UACR from spot morning urine had similar accuracy in screening microalbuminuria. The simplicity and lower cost of UAC justifies its preferential clinical use.