15/12/2024
According to the latest recommendations of the American Diabetes Association ADA 2024
1- albumin-to-creatinine ratio analysis and eGFR analysis should be requested.
At least once a year for Type 2 DM patients and also for Type 1 DM patients if 5 years have passed since their diagnosis (i.e. type 1 patients)
2- In the past, we used to rely on Microalbuminuria analysis, but now we rely on albumin-to-creatinine ratio analysis
3- The Albumin-to-Creatinine Ratio analysis is more accurate than the Microalbuminuria measurement alone in detecting kidney problems early, especially in diabetics.
Why is ACR more accurate?
The analysis is more accurate: because it measures the amount of albumin in the urine relative to the amount of creatinine, which makes the result more accurate because it is not affected by variations in urine concentration that occur for many reasons, including hydration status.
Detects kidney problems early: ACR analysis detects even small amounts of albumin in the urine, which may be the first sign of a kidney problem, and also gives a specific number with which we can follow the condition and see if it is improving or not.
4- Medical recommendations: Most medical recommendations, such as those from the American Diabetes Association (ADA) and the National Kidney Foundation (NKF), recommend the use of ACR analysis because it is more accurate in following up diabetics cases in order to detect any kidney problems early.
5- For the analysis of Microalbuminuria:
It measures the amount of albumin in the urine, and determines if it is in a small amount (usually between 30-300 mg/g creatinine), this is a sign that there is a problem that may start in the kidneys, but it is not as accurate as ACR because it does not calculate urine concentration.
The bottom line:
The analysis of the Albumin-to-Creatinine Ratio (ACR) is more accurate and better for monitoring kidney health, especially in diabetics, because it has a clearer and more regular result than measuring microalbuminuria alone.
The importance of checking the ratio of albumin to creatinine (ACR)
Albumin-to-creatinine (ACR) screening is used to evaluate kidney function and detect albuminuria, which is an early sign of kidney damage, which is common in diabetics due to the disease's effect on the tiny blood vessels in the kidneys.
Important:
1. Early diagnosis of kidney damage:
It helps detect the leakage of small amounts of albumin (protein) into the urine, which is the first indication of impaired kidney function.
2. Heart Disease Risk Assessment:
A high level of albumin in the urine is associated with an increased risk of cardiovascular disease.
3. Follow up the development of diabetic kidney disease:
Screening is used to monitor the progress of the condition and respond to treatment.
4. Determine the need for medical intervention:
The results of the examination help doctors make decisions about modifying treatment or lifestyle changes.
Normal ratios of albumin to creatinine ratio:
Natural: less than 30 mg/g
Slight increase (microalbuminuria): 30 - 300 mg/g (indication of early kidney damage).
Significant increase (macroalbuminuria): more than 300 mg/g (indication of significant kidney damage).
Tips for diabetics to maintain kidney health:
1. Control blood sugar.
2. Control blood pressure (less than 130/80).
3. Avoid taking medications that adversely affect the kidneys without consulting a doctor.
4. Commit to taking ACE inhibitors or angiotensin receptor blockers (ARBs) if prescribed by a doctor.
5. Periodic check-up of albumin-to-creatinine ratio every 6 - 12 months.If you have diabetes, early and periodic monitoring of kidney function with an ACR scan can protect the kidneys from long-term damage.
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