微量白蛋白尿
| 微量白蛋白尿 | |
|---|---|
| 类型 | 白蛋白尿 |
| 分类和外部资源 | |
| 醫學專科 | 腎臟科 |
| ICD-11 | GB42.0 |
| ICD-9-CM | 791.0 |
| MedlinePlus | 003591 |
微量白蛋白尿（microalbuminuria）是尿中白蛋白含量超出健康人的参考范围，但不能用常规方法检测出来的尿液。其量化定义为用特殊方法测得尿白蛋白排泄速率为 20～200μg/min 或 30～300mg/d；或是一次性尿白蛋白/肌酐值为 2.5～25mg/mmol（男）和 3.5～35mg/mmol（女）。
微量白蛋白尿發生在腎洩漏少量白蛋白進入尿液裡，即在腎小球的白蛋白有異常高的血管通透性（vascular permeability）。目前国际肾脏病组织“肾脏病：改善全球预后”（Kidney Disease: Improving Global Outcomes，KDIGO[1][2]）並不建議使用術語“微量白蛋白尿”，其使用“中度增加白蛋白尿”（moderately increased albuminuria）取代之[3]。
病因
[编辑]- 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
[编辑]| 個人 | 底限 | 高限 | 單位 | |
|---|---|---|---|---|
| 24小時尿液收集 | 30[4] | 300[4] | mg/24h (每24小時的毫克白蛋白) | |
| 短時間尿液收集 | 20[4] | 200[4] | µg/min (每分鐘的微克白蛋白) | |
| 定點白蛋白尿樣本 | 30[5] | 300[5] | 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[6] | 25[6] or 35[6] | mg/mmol (每摩爾肌酸酐的毫克白蛋白) |
| 30[6] | 400[6] | μg/mg (每毫克肌酸酐的毫克白蛋白) | ||
| 男人 | 2.5[6] or 3.5[6] | 25[6] or 35[6] | mg/mmol | |
| 30[6] | 300[6] | μg/mg |
參見
[编辑]註釋
[编辑]- ^ Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117-S314. doi:10.1016/j.kint.2023.10.018
- ^ History of Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO.
- ^ KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease (PDF).
- ^ 4.0 4.1 4.2 4.3 Page 90 in: Basic Skills in Interpreting Laboratory Data. ISBN 978-1-58528-180-0.
- ^ 5.0 5.1 Person—microalbumin level (measured) （页面存档备份，存于互联网档案馆） at Australian Institute of Health and Welfare. 01/03/2005
- ^ 6.00 6.01 6.02 6.03 6.04 6.05 6.06 6.07 6.08 6.09 6.10 [1] （页面存档备份，存于互联网档案馆） Thomas I. Justesen, Jens L. A. Petersen, Pia Ekbom, Peter Damm, Elisabeth R. Mathiesen. Albumin-to-creatinine ratio in random urine samples might replace 24-h urine collections in screening for micro- and macroalbuminuria in pregnant woman with type 1 diabetes. Diabetes Care. 2006-4, 29 (4): 924–925 [2019-02-13]. ISSN 0149-5992. PMID 16567839. （原始内容存档于2019-08-22）.
參考文獻
[编辑]- 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.
- 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.
- 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.
- 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
[编辑]- Microalbumin and Urine Albumin/Creatinine Ratio （页面存档备份，存于互联网档案馆） – Lab Tests Online
- Online Microalbumin Urine Calculator （页面存档备份，存于互联网档案馆）