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Spot Urine for Albumin/Creatinine Ratio

Done annually, this is a surrogate measure for the amount of protein a diabetic patient spills into his urine in a 24 hour period, which in turn indicates the status of the patient’s kidney disease related to diabetes.

Individuals with a urine albumin/creatinine ratio >30 outside of a recent illness, kidney infection or known hematuria, have evidence of nephropathy and even if they do not have high blood pressure should be on an ACE or ARB medication.

If they have a urine albumin/creatinine ratio >300, the blood pressure goal is lowered further from <130/80 to <125/75.

Serum or Plasma Creatinine

The ADA recommends that an estimated GFR should also be done annually to evaluate for kidney diseases that may not be detected by albuminuria alone. The estimated GFR is calculated using the plasma creatinine, age, gender, and ethnicity (African-American or not).

There are several websites where you can enter the data to calculate it, including the National Kidney Disease Education Program: http://www.nkdep.nih.gov/. The GFR is also automatically calculated any time you order a serum creatinine at The Nebraska Medical Center laboratory.