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| 4 | 2009
Klinisk Biokemi i Norden
A taste of the scientific program
Symposium ”Biomarkers in renal disease”
Professor Greg Miller: U-albumin: What
sample to collect and what units to use.
Dr Greg Miller is professor of
Pathology at the Virginia Com-
monwealth University, USA.
He is chair of the Laboratory
Working Group of the NKDEP
(National Kidney Disease Edu-
cation Program) and the Joint
NKDEP-IFCC Working Group
for Standardization of Albumin
in Urine.
During the last years urine albumin testing has
been recommended not only for diabetic patients but
also to evaluate target organ damage for patients with
hypertension and cardiovascular disease. Some of the
newer clinical guidelines on renal disease advocate
urine albumin to replace urine protein as the primary
screening test for kidney damage. A number of urine
albumin measurement issues are under investigation
including: the molecular forms of albumin that are
most important in kidney disease, the influence of
various urine matrix components, and the heteroge-
neity in antibody reactivity. No international refer-
ence material nor reference measurement procedure
is available for urine albumin, although both are in
development. The current practice is to trace calibra-
tion for urine albumin to CRM 470, which is a serum
protein reference material, but dilution protocols are
not standardized and there is variability of results
between different methods.
There has been an ongoing debate on how to per-
form urine albumin testing and there is large diver-
sity in actual practice. There is confusion about type
of urine sample to collect (random, first or second
morning, timed, overnight, 24-hour). The different
sample types and test procedures have lead to use of
different reporting units and a variety of reporting
options (e.g. albumin concentration, albumin excre-
tion, albumin-to-creatinine ratio). Finally there is a
discussion on what cut-off value to apply, should spe-
cific cut-off values for gender, race, and age be imple-
mented or is a single cut-off value sufficient. Studies
evaluating biological variation of urine albumin show
diverse results and there has been a large heterogene-
ity in study design. These issues make interpretation
of urine albumin results difficult, and lack of consen-
sus may influence follow-up and treatment of patients
in an inappropriate way.
Professor Greg Miller will in his talk “U-albumin:
What sample to collect and what units to use” during
the symposia “Biomarkers in renal disease” highlight
these issues and give the current status of the impor-
tant work to standardize urine albumin measure-
ments, reporting and interpretation of test results.
Labmed 2010
News
Nr. 4
XXXII Nordic Congress in Medical Biochemistry
Facts of today - visions for tomorrow
Oslo, June 1-4 2009
General information
The planning of the scientific program, of the social activities, housing, invitation to
sponsors and exhibitors are on the track according to our time schedule.
Find updated information on
www.labmed2010.no
