Microalbumin and Kidney Disease in Cats

What is microalbuminuria?

Albumin is an important protein that is found in large quantities in the blood but is not normally present in the urine of healthy cats. The term microalbuminuria refers to the presence of very small amounts of albumin in urine.

Microalbuminuria may indicate underlying health problems and is sometimes an early warning sign of primary kidney disease (also known as renal disease).

What sorts of conditions result in microalbuminuria?

Many conditions can potentially lead to microalbuminuria. including inflammatory conditions (e.g., dental disease, chronic skin disease, bowel inflammation), infectious disease (e.g., feline leukemia virus, feline immunodeficiency virus), metabolic disorders (e.g., diabetes mellitus, hyperthyroidism), hypertension (high blood pressure), cancer, and kidney disease.

When may a test for microalbuminuria be recommended?

The microalbuminuria test will detect minute amounts of protein in urine compared to the routine urine “dipstick” test (see handout “Urinalysis”). The microalbuminuria test is used when the routine urine test for protein is negative and your veterinarian wants to look further for traces of protein in the urine (e.g., in a cat at high risk for kidney disease) or do a comprehensive health screen to detect hidden illness in a cat.

Microalbumuria testing should not be done when:

• a routine urine test is positive for protein. In this situation, there is clearly excess protein in the urine and microalbuminuria testing will not provide any additional information.Your veterinarian may suggest doing a urine protein:creatinine ratio test, which is the best test when larger amounts of protein are present in the urine. See handout “Urine Protein:Creatinine Ratios” information.
• there are obvious signs of inflammation, infection, or bleeding in the urinary system. The large amount of inflammatory protein in the urine would give a falsely high microalbuminuria reading.

What sample is needed to test for microalbuminuria?

All that is needed is a small amount of urine collected in a sterile container. The sample can be stored in the refrigerator for up to 24 hours, but your veterinarian may want to collect fresh urine from your cat for the test.

If my cat has microalbuminuria, does this mean my pet has serious kidney disease?

No. In fact, the majority of cats with microalbuminuria will not develop kidney disease.

In most cases, treatment or management of the underlying health problem will make the microalbuminuria disappear. It is only in a small percentage of cats that microalbuminuria is truly a warning sign of early kidney disease. These cats may go on to develop serious kidney disease and possibly kidney failure. Although a complete cure may not be possible, specific steps, such as a prescription diet and medications,

If my cat has microalbuminuria, what is the next step?

If microalbuminuria is detected, your veterinarian will likely recommend further testing to look for hidden disease. The choice of tests may vary but could include basic blood tests and urinalysis (see handouts “Complete Blood Count”, “Serum Biochemistry”, and “Urinalysis” for more information). If there is no evidence of underlying illness, then regular check-ups every 3-6 months, including microalbuminuria testing, may be recommended to monitor the pet's health status and to watch any changes.