Laboratory and diagnostic testing: a perioperative update

AORN Journal,  April, 2007  by Kathleen D. Pagana

• E-mail
• Print
• Link

Microalbuminuria

Mr V is a 37-year-old man with an umbilical hernia and a history of diabetes and moderate obesity. At his preoperative physical examination, his physician notes that Mr V's blood glucose and urine microalbumin are elevated. The physician also notes, however, that no protein was detected in the patient's urine. At the postoperative follow-up visit, the physician explains his concern about the possibility of Mr V developing diabetic nephropathy and hypertension. He strongly advises Mr V to restrict calories, lose weight, and increase his level of exercise.

One year tater, Mr V returns for his annual physical assessment. He has lost 23 lbs and his blood pressure, blood sugar, and microalbumin levels are within normal limits. The physician explains to the patient that the presence of elevated levels of microalbumin in his urine was a bad sign but that the change in his health habits have helped him avoid renal failure.

MICROALBUMINURIA

Information at a Glance

What is the normal value for microalbumin in the urine?

< 20 mg/L or < 30 mg/day

What type of sample is needed?

A random, timed, or 24-hour urine specimen

Ce indicates that continuing education contact hours are available for this activity. Earn the continuing education contact hours by reading this article and taking the examination on pages 763-764 and then completing the answer sheet and learner evaluation on pages 765-766.

You also may access this article online at http://www .aornjournal.org.

RESOURCES

Cembrowski GS. Testing for microalbuminuria: promises and pitfalls. Lab Med. 1990;21:491.

Dachman AH, Yoshida H. Virtual colonoscopy: past, present, and future. Radiol Clin North Am. 2003;41:377-393.

Lieberman D. Colonoscopy: good as gold? Ann Intern Med. 2004;141:401-403.

MacIsaac RJ, Jerums G, Cooper ME. New insights into the significance of microalbuminuria. Curr Opin Nephrol Hypertens. 2004; 13:83-91.

Pickhardt PJ, Nugent PA, Mysliwiec PA, Choi JR, Schindler WR. Location of adenomas missed by optical colonoscopy. Ann Intern Med. 2004;141:352-359.

Tsioufis C, Dimitriadis K, Antoniadis D, Stefanadis C, Kallikazaros I. Interrelationships of microalbuminuria with other surrogates of the atherosclerotic cardiovascular disease in hypertensive subjects. Am J Hypertens. 2004;17:470-476.

van Dam J, Cotton P, Johnson CD, et al. AGA future trends report: CT colonography. Gastroenterology. 2004;127:970-984.

Yudkin JS, Forrest RD, Jackson CA. Microalbuminuria as a predictor of vascular disease in non-diabetic subjects. Islington Diabetes Survey. Lancet. 1988;2:530-533.

REFERENCES

(1.) Bhatia V, Nayyar P, Dhindsa S. Brain natriuretic peptide in diagnosis and treatment of heart failure. J Postgrad Med. 2003;49:182-185.

(2.) Maisel AS, Krishnaswamy P, Nowak RM, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347: 161-167.

(3.) Januzzi JL, Camargo CA, Anwaruddin S, et al. The N-terminal Pro-BNP investigation of dyspnea in the emergency department (PRIDE) study. Am J Cardiol. 2005;95:948-954.