Chronic Kidney Disease: Proteinuria

Key points

• Chronic kidney disease: proteinuria Proteinuria is an important marker of chronic kidney disease, especially for diabetic nephropathy.
• by collecting a 'spot' sample it avoids the need to collect urine over a 24 hour period in order to detect or quantify proteinuria
• should be a first-pass morning urine specimen
• if the initial ACR is between 3 mg/mmol and 70 mg/mmol, this should be confirmed by a subsequent early morning sample. If the initial ACR is 70 mg/mmol or more, a repeat sample need not be tested. Interpreting the ACR results
• the NICE guidelines state 'regard a confirmed ACR of 3 mg/mmol or more as clinically important proteinuria' NICE recommendations for referral to a nephrologist: