Albuminuria

Albuminuria is often asymptomatic in low quantities but foamy urine may be present. As significant albumin is lost to the urine, swelling of the ankles, hands, belly or face may occur (see edema and nephrotic syndrome). This is because a major role of albumin in the blood is to act as an osmotic agent, keeping water from leaving blood vessels and leaking into the surrounding body tissues.{{cite journal | vauthors = Levitt DG, Levitt MD | title = Human serum albumin homeostasis: a new look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements | journal = International Journal of General Medicine | volume = 9 | pages = 229–255 | date = 2016 | pmid = 27486341 | pmc = 4956071 | doi = 10.2147/ijgm.s102819 | doi-access = free }}

Albuminuria is not a disease itself but a marker of kidney injury, particularly to the filtration mechanism (glomerulus), and can be caused by a number of pathological states, including:

• Diabetic nephropathy
• Hypertension
• Various autoimmune disorders
• Lupus nephritis
• IgA nephropathy
• ANCA-associated vasculitis
• Anti-GBM disease (Goodpasture's syndrome)
• Membranous nephropathy
• Antiphospholipid syndrome
• Alport syndrome
• Sjogren syndrome
• Dehydration / low blood volume
• Cardiovascular disease
• Nephrotoxic medications
• Infections
• Urinary tract obstruction

In all cases, the result is a loss of the kidney's ability to retain albumin from the urine.

According to Kidney Disease Improving Global Outcomes (KDIGO) guidelines, albuminuria is currently categorized into 3 grades with increasing severity of associated kidney injury: A1, A2, and A3. This grading scale, along with estimated glomerular filtration rate, is used to assess risk of progression and severity of kidney disease, particularly in chronic kidney disease.

Various tests are available to measure albuminuria. [https://www.mayoclinic.org/tests-procedures/urinalysis/about/pac-20384907#:~:text=A%20dipstick%20%E2%80%94%20a%20thin%2C%20plastic%20stick,typical%20levels.%20A%20dipstick%20test%20checks%20for: Urine dipstick analysis] can provide a qualitative estimate of the amount of albumin in the urine sample. More quantitative and accurate testing include a [https://www.kidney.org/kidney-topics/urine-albumin-creatinine-ratio-uacr#:~:text=categories%20or%20ranges.-,This%20test%20only%20requires%20a%20one%2Dtime%20urine%20sample%2C%20also,check%20using%20the%20dipstick%20method. spot sample urinalysis] and a [https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/24hour-urine-collection#:~:text=What%20is%20a%2024%2Dhour,High%20blood%20pressure. 24-hour urine collection analysis].{{Cite web |title=Urine albumin-creatinine ratio (uACR) {{!}} National Kidney Foundation |url=https://www.kidney.org/kidney-topics/urine-albumin-creatinine-ratio-uacr#:~:text=categories%20or%20ranges.-,This%20test%20only%20requires%20a%20one-time%20urine%20sample,%20also,check%20using%20the%20dipstick%20method. |access-date=2025-03-19 |website=www.kidney.org |language=en}}

Because albuminuria is a sign of underlying kidney injury/disease, treatment should be aimed at the causative factor/s. Common methods of improving and preserving kidney function include medication and lifestyle modifications such as diet and exercise.{{Cite journal |last1=Ma |first1=Qirui |last2=Gao |first2=Ye |last3=Lu |first3=Jiandong |last4=Liu |first4=Xinhong |last5=Wang |first5=Ruolin |last6=Shi |first6=Yajun |last7=Liu |first7=Jingqi |last8=Su |first8=Hao |date=2022-09-26 |title=The effect of regular aerobic exercise on renal function in patients with CKD: A systematic review and meta-analysis |journal=Frontiers in Physiology |language=English |volume=13 |doi=10.3389/fphys.2022.901164 |doi-access=free |issn=1664-042X |pmc=9549134 |pmid=36225309}} Blood pressure control, especially with the use of inhibitors of the renin-angiotensin-system, is the most commonly used therapy to control albuminuria.{{cite journal | vauthors = Ksiazek SH, Hu L, Andò S, Pirklbauer M, Säemann MD, Ruotolo C, Zaza G, La Manna G, De Nicola L, Mayer G, Provenzano M | title = Renin-Angiotensin-Aldosterone System: From History to Practice of a Secular Topic | journal = International Journal of Molecular Sciences | volume = 25 | issue = 7 | pages = 4035 | date = April 2024 | pmid = 38612843 | pmc = 11012036 | doi = 10.3390/ijms25074035 | doi-access = free }}

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{{EB1911 poster|Albuminuria}}

{{Abnormal clinical and laboratory findings for urine}}

Category:Abnormal clinical and laboratory findings for urine