Definition
Testing urine for albumin—a key protein normally retained in the bloodstream—is essential for detecting early kidney damage, especially in patients with diabetes, hypertension, or cardiovascular risk.
Why Testing urine for Albumin?
- Albuminuria (presence of albumin in urine) is an early marker of kidney disease.
- Healthy kidneys do not allow albumin to pass into urine; its presence suggests glomerular damage.
- It’s often asymptomatic, so routine screening is vital for at-risk individuals.
Common Testing Methods
| Test | Description |
|---|---|
| Dipstick Test | Quick, qualitative test using a chemically treated strip; changes color if albumin is present. |
| Urine Albumin-to-Creatinine Ratio (uACR) | Quantitative test measuring albumin relative to creatinine in a spot urine sample. Preferred for accuracy. |
| 24-Hour Urine Collection | Measures total albumin excreted in 24 hours; used for confirmation or detailed analysis. |
Interpretation of uACR Results
| uACR Level | Interpretation |
|---|---|
| <30 mg/g | Normal |
| 30–299 mg/g | Moderately increased (albuminuria) |
| ≥300 mg/g | Severely increased (clinical proteinuria) |
Persistent elevation over 3 months indicates chronic kidney disease (CKD).
Articles
- Spirit lamp.
- Match box.
- Test tube and holder.
- Test tube stand.
- 2% solution acetic acid.
- Dгорреr.
- Specimen container.
- Duster.
- Kidney tray.
- Litmus paper to check the reaction of urine (acidity/alkalinity).
- Clean gloves.
Procedure
| S.No | NURSING ACTIONS | RATIONALE |
| 1. | Before procedure Explain to the patient about the test to be done and provide container for collecting urine. | Obtains cooperation of patient. |
| 2. | During procedure Don gloves. | |
| 3. | Hot test method: Fill 3/4th of a test tube with urine, secure test tube holder at its top end. | |
| 4. | Check the reaction of urine. If it is alkaline, add one drop of acetic acid to adjust the pH. | If the urine is highly alkaline or acidic, it will give false reading, PH of urine should be adjusted before conducting test. |
| 5. | Heat the upper third of urine over a spirit lamp and allow it to boil. Keep the mouth of the test tube away from your face. | Prevents scalding. |
| 6. | A cloud may appear either due to phosphate or albumin2-3 drops of acetic acid into the test tube. If the urine still remains cloudy, it indicates the presence of albumin. Clear =nil Trace =+ Cloudy =++ Thick cloudiness =+++ If it becomes clear, it indicates the presence of phosphates. | Confirms the presence of albumin. Normal urine does not contain albumin. |
| 7. | Cold method: It involves dropping similar quantity of urine with dropper gradually along the sides of test tube into a clean dry test tube containing 2 cc of nitric acid. Inference: Appearance of a white ring at junction of urine and acid shows presence of albumin. | |
| 8. | After procedure Discard the urine and rinse the test tube. Replace articles. | Cleaning the test tube and keeping ready helps for the next use. |
| 9. | Discard gloves and wash hands. | Prevents transmission of microorganisms. |
| 10. | Record the procedure with date and time in nurses’ record or flow sheet according to hospital policy. | Gives the information about patient’s health status. |
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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