COMMENTARY

Microalbuminuria: Is It Even a Word Anymore?

George L. Bakris, MD; Richard J. Glassock, MD

Disclosures

June 03, 2013

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In This Article

George L. Bakris, MD: Good day. I am Dr. George Bakris, Professor of Medicine and Director of the American Society of Hypertension Comprehensive Hypertension Center at the University of Chicago Pritzker School of Medicine. I am here today via Skype with Dr. Richard Glassock, who is Professor Emeritus at UCLA School of Medicine and former Chairman of the Nephrology Department there.

Today, we will be talking about a topic that is very commonly discussed across medicine, and that is microalbuminuria. What is new? What does it mean? Is microalbuminuria still considered a risk factor? Is it a risk marker? Is it relevant to kidney and cardiovascular risk? Is it relevant to cardiovascular risk alone? Where do we stand with this?

This has been a hotly debated and evolving topic at the US Food and Drug Administration (FDA) and within the nephrology community over the past 3 or 4 years. We will try to bring you up to speed today on where we are in the current state of knowledge. Dick, thank you very much for joining us, and welcome.

Richard J. Glassock, MD: Thank you very much for having me.

Dr. Bakris: Let's talk about the spectrum as it is now. Of course, microalbuminuria is the old term that everyone is familiar with. The new guidelines from the Kidney Disease: Improving Global Outcomes (KDIGO) group, the international guidelines,[1] have now pegged a different term: moderately increased albumin. What do you think about the new nomenclature? What is it? Is it better or more confusing? What are your thoughts?

Dr. Glassock: Personally, I like the term "microalbuminuria." The term has good historical precedent, even though it is a bit confusing, since we are not talking about "small albumin" but rather small amounts of albumin. I think the general public understands that. "Moderate" albuminuria adds a level of confusion that may not enlighten, in my opinion.

Dr. Bakris: Do you think there is a bit of a bias toward the people who came up with this term, to try to bring the point home that it is a bigger deal than it is?

Dr. Glassock: This school of thought certainly adopts the view that small amounts of albumin are the key issue in determining the long-term outcome of a variety of disease states. Perhaps the use of "moderate" instead of "micro" gives a higher level of interest to that particular measurement.

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