1987 年 2 巻 3 号 p. 195-201
One hundred consecutive insulin-treated diabetic patients with a normal serum creatinine value admitted to a Diabetes Day Care Unit were investigated. Because we were studying microalbuminuria, 20 patients with persistently positive Albustix tests had to be excluded. The albumin/creatinine clearance ratio, a test used to determine albuminuria in renal diseases since 1973, determines the loss of albumin from the total glomerular surface and has, in contrast to other methods for measurement of microalbuminuria, the advantage of being uninfluenced by diuresis. The albumin/creatinine clearance ratio, in comparison with random urinary albumin concentration, correlated well with 24-h urinary albumin excretion (r=0.74, p<0.001). Furthermore, the albumin/creatinine clearance ratio correlated (p<0.001) with glycemic control (HbA1c; r=0.41) and with blood pressure (diastolic BP; r=0.50). The ratio (×10-3) was higher in patients with HbA1c≥8.7% (median value) (0.02±0.01, p<0.01), or diastolic BP≥90mmHg (0.05±0.02, p<0.001), or both (0.07±0.01, p<0.001), compared with those with HbA1c<8.7% and diastolic BP<90mmHg (0.003±0.001). The albumin/creatinine clearance ratio, determined from a single blood and urine sample, is a convenient and experienced test useful when screening for microalbuminuria. The ratio is related to glycemic control and blood pressure.
