Table II.

Microproteinuria

What Is It?

Excretion of small amounts (30–300 mg/d) of protein in the urine. May be present in patients with insulin resistance prior to development of clinical diabetes.

How Is It Determined?

Spot morning urine sample for protein (creatinine levels in the urine to determine the percentage of 24‐hour urine volume excreted). Use albumin‐to‐creatinine ratio; <0.03 indicates proteinuria

What Testing Methods are Available?

Micral II dipstick ($4–$7/strip) and spot urine for albumin‐to‐creatinine ratio ($12–$14)

What Does It Mean?

Is suggestive of vascular injury not just in the kidney but in blood vessels elsewhere (correlates with cardiovascular risk)

What Should Be Done About It?

Glycemic control; control of blood pressure to levels <130–135/80–85 mm Hg

Is Specific Therapy Needed?

The use of an angiotensin‐converting enzyme inhibitor or an angiotensin receptor blocker usually with a diuretic; probably represents the most appropriate therapy to lower blood pressure and reduce proteinuria.

Adapted from Moser and Sowers. 11