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171 - Survey on quantitative measurement of urinary albumin in Italian laboratories

Autor(s): M.S. Graziani, C. Lo Cascio, A.L. Caldini, F. Ghiara, B. Salvadori, S. Secchiero, R. Testa, A. Mosca

Issue: RIMeL - IJLaM, Vol. 3, N. 3, 2007 (MAF Servizi srl ed.)

Page(s): 171-177

Background. The quantitative measurement of urinary albumin is a key-point in the management of diabetic patients. However standardization of this assay is still lacking. In order to investigate this aspect a survey has been performed among several Italian laboratories. Methods. A questionnaire with 21 questions has been distributed to the members of two Italian Societies (SIBioC and SIMeL) and to the participants to an EQAS scheme. The answers have been collected by fax and deposited in a database. Questions concerned the main pre-analytical, analytical and post-analytical aspects. Results. We have collected 153 questionnaires. The sample
mostly used to measure albumin in urine was the 24 hr sample (56% of the answers), followed by the spot sample (18%), and the timely-collected sample (8%). Turbidimetric methods were used by the majority of the laboratories (55%), followed by nephelometric methods (39%). Internal Quality Control procedures are adopted by 85% of the laboratories, while EQAS exercises were perfomed only by a minority (28%). A great variety of measurements units were used. Thirtyseven% of the participants to the survey reported 24 hr excretion mass, 32% concentration in terms of mass per volume of urine, 22% ratio to urinary creatinine and 11% excretion mass per minute. Different units such as µg, mg, dL, L, mol were reported within the same category of report. Only in 36% of the participants the reference ranges for urinary albumin were found in agreement with the recommendations of the American Diabetes Society. Conclusions. From the data we have collected it is evident that only a minority of the laboratories follow the present recommendations on the measurement of urinary albumin. A major campaign of information and education is strongly needed.

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