Micral-Test®

  • Urinary albumin excretion of 20 to 200 mg/L is called microalbuminuria.
  • Microalbuminuria is an early indication of renal and cardiovascular diseases, which are both characterized by persistent albuminuria. Detection of microalbuminuria can aid diagnosis and treatment of incipient nephropathy in persons with diabetes and hypertension14
  • In addition,microalbuminuria is a predictor in the general population for cardiovascular outcomes independent of other risk factors such as hyperlipidemia, hypertension or diabetes15,16
  • A reduction of albumin excretion means the reduction of cardiovascular risk and kidney disease
  • Micral-Test is a simple, efficient and cost-effective




People with cardivascular risk

Evidence shows that microalbuminuria is a powerful cardiovascular risk factor in the nondiabetic, normotensive general population.

  • Published studies have demonstrated that microalbuminuria is not uncommon in the apparently healthy general population and is independently associated with increased cardiovascular risk factors and cardiovascular morbidity1
  • Microalbuminuria, and even normal albuminuria in the upper normal range, are meaningful indicators for future cardiovascular events as well as for cardiovascular and non-cardiovascular mortality2-4

People with diabetes mellitus

Microalbuminuria is an early manifestation of diabetic nephropathy and an independent marker of increased cardiovascular morbidity and mortality
for patients with type 1 or type 2 diabetes mellitus

  • Diabetes is the most frequent primary diagnosis in patients with end-stage renal disease5
  • Death rates from cardiovascular disease in adults with diabetes are two to four times higher than for those without diabetes6

People with hypertension

Microalbuminuria in essential hypertension is an integrated marker of cardiovascular risk and target organ damage7

  • In hypertensive patients with microalbuminuria, the prevalence of coronary artery disease, left ventricular hypertension, stroke and peripheral vascular disease is higher than in patients without microalbuminuria8
  • Hypertension is the second frequent primary diagnosis in patients with end-stage renal disease5

Each patient with diabetes duration of more than 5 years should be screened annually for microalbuminuria, with 3 urine samples within few days. Positive results should be verified by a quantitative determination of the urinary albumin excretion e.g. by Tina-quant® Albumin in Urine, preferably with a timed overnight urine sample. Patients with hypertension should be screened for microalbuminuria too.

References

1. Hillege HL, Janssen WM, Bak AA et al. Microalbuminuria is common, also in a nondiabetic, nonhypertensive population, and an independent indicator of cardiovascular morbidity.
J Intern Med 2001; 249:519-526.
2. Hillege HL, Fidler V, Diercks FH et al. Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general publication. Circulation 2002; 106: 1777-1782.
3. Ärnlöv J, Evans JC, Meigs JB et al., Low-grade albuminuria and incidence of cardiovascular disease events in nonhypertensive and nondiabetic individuals. The Framingham Study. Circulation.
2005;112:969-975.
4. Yuyun M-F, Khaw K-T, Luben R et al., Microalbuminuria independently predicts all-cause and cardiovascular mortality in a British population: The European Prospective Investigation into cancer in
Norfolk (EPIC-Norfolk) population study. Internat J of Epidemiology 2004; 33: 189-198.
5. US Renal Data System (USRDS) Annual Data Report, 2000.
6. CDC. National Diabetes fact sheet: general information and national estimates on diabetes in the United States, 2002. Atlanta, GA: U.S. Department of Health and Human Services, 2003.
7. Pontremoli R, Leoncini G, Ravera M et al. Microalbuminuria, cardiovascular, and renal risk in primary hypertension. J Am Soc Nephrol 2002;13:S 169-S172.
8. Agrawal B, Berger A, Wolf K, Luft FC. Microalbuminuria screening by reagent strip predicts cardiovascular risk in hypertension. J Hypertens 1996 ; 14:223-228.
9. Mogensen CE, Vestbo E, Poulsen PL, et al. Microalbuminuria and potential confounders. A review and some observations on variability of urinary albumin excretion. Diabetes Care 1995; 4: 572-581.
10. Mogensen CE, Viberti GC, Peheim E et al.: Multicentre evaluation of the Micral-Test II test strip, an immunological rapid test for the detection of microalbuminuria. Diabetes Care 1997; 20:1642-1646.
11. Gilbert RE,. Akdeniz AQ, Jerums G: Detection of microalbuminuria in diabetic patients by urinary dipstick. Diabetes. Research and Clinical Practice 1997; 35: 57-60.
12. Poulsen PL, Mogensen CE: Evaluation of a new semiquantitative stix for microalbuminuria. Diabetes Care 1995; 18: 732-733.
13. Kutter D, Thoma J, Kremer AS, Hansen S, Carl R: Screening for oligoalbuminuria by means of Micral-Test II - a new immunological test strip. Eur. J. Clin. Chem. Clin Biochem 1995; 33: 243-245.

 

14) Ch. Hasslacher, Akt. Endokr. Stoffw. 10 (1989) 60–63
15) J. Ärnlöv et al., Circulation 112 (2005) 969–975
16) K. Klausen et al., Circulation 110 (2004) 32–35

Expected Values:

  • The albumin concentration of an average urine specimen should not exceed 15–20 mg/L. 2
  • Clinical diabetic nephropathy is indicated when microalbuminuria (> 20 mg/L) is present in at least two of the three morning urine samples.3
  • A normal microalbuminuria value does not rule out renal disease.1

Reaction principle: Immunological detection of human albumin by anti-human albumin IgG labeled with colloidal gold (mouse)

Measuring time: 1 min (colour stable to 5 min)
Measuring range: From Negative to 100 mg/L
Results: Visual comparison with the color scale printed on the vial label: Neg., 20 mg/L, 50 mg/L and 100 mg/L
Sample material: Urine (preferably early morning urine), storage 3 days max. at room temperature, 2 weeks at 2-8°C
Strip storage conditions: From 2 ° to 8°C, the test strips are stable up to the expiry date. From room temperatures up to +30 °C, the strips are stable for 6 months


  • All pads can be read 60 seconds after dipping
  • Applied nylon mesh ensures uniform color development through uniform penetration of the urine
  • Separate diazonium salt mesh improves reagent stability and color differentiation in the leukocytes test
  • virtually eliminating vitamin C interference on the glucose and blood pads


  • All pads can be read 60 seconds after dipping
  • Applied nylon mesh ensures uniform color development through uniform penetration of the urine
  • Separate diazonium salt mesh improves reagent stability and color differentiation in the leukocytes test
  • virtually eliminating vitamin C interference on the glucose and blood pads


  • All pads can be read 60 seconds after dipping
  • Applied nylon mesh ensures uniform color development through uniform penetration of the urine
  • Separate diazonium salt mesh improves reagent stability and color differentiation in the leukocytes test
  • virtually eliminating vitamin C interference on the glucose and blood pads

Cut off 15 mg/L Cut off 20 mg/dL
Sensitivity 95% 97%
Specificity 93% 72%
Negative predictive value 88% 94%
Positive predictive value 97% 84%

1. American Diabetes Association. “Consensus development conference on the diagnosis and management of nephropathy in patients with diabetes mellitus.” Diabetes Care. 1994;17:1357-1361
2. Cembrowski G, Testing for Microalbuminuria: Promises and Pitfalls, Laboratory Medicine, 21: 491-496, August 1990.
3. Mogensen CE, Cohen JJ, Jarrington JT, et al:
Microalbuminuria as a predictor of clinical diabetic nephropathy. Kidney Int., 31: 673-689, 1987.

  • Quick result in about one minute with convenient handling
  • Convenient: only one test for several indications
  • No lab equipment necessary
  • Cost-effective (especially regarding the prevention of long-term complications)

This offers an easy, reliable way to help you

  • identify patients at risk
  • intervene more effectively
  • prevent or delay the development of serious cardiovascular complications