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Nephrology/microalbumin/creatine ratio


My sister went to the dr, and found out her microalbumin/creatine ratio was 4200, and creatine was 1.2 .  The first time she had the test done, m/a ratio was 2000.  Yrs later, it was 4000.  Then recently, it's gone up to 4200.  She has been diabetic for 34 yrs.  She's on bp medicines to help slow the progression of kidney disease, along with the bp of course.  I know each individual is different, but was wondering how high the micoalbumin/creatine ratio can go before dialysis is inevitable.  Thanks.


Thanks for rating my answer on "Allexperts". Your comments are quoted below:

"i think the answer had absolutely nothing to do with my question! And the answer they did give said something about the protein and albumin in the urine has nothing to do with dialysis! BS! Any dr will tell you that high amounts of protein and albumin in the urine is an indication of KIDNEY DISEASE, WHICH CAN LEAD TO DIALYSIS ONCE IT'S HIGH ENOUGH! So please don't sit there and say that a 4200 micro albumin/creatine ratio test is no 'direct' relation to dialysis. This fellow def needs more training. Thanks."

You seem to be in agreement with what I answered earlier. Your yourself say that "albumin in urine is an indication of KIDNEY DISEASE, WHICH CAN LEAD TO DIALYSIS ONCE IT'S HIGH ENOUGH." That is exactly what I have said in my answer below. Your concern about my needing more training is duly noted. More than me, however, you need to go back to school because it is apparent that you cannot read and understand plain English. Also, did you know that writing in capital letters on the internet is equivalent to shouting? Please learn some manners while you are learning English!

Dr. Shah


Thanks for your question on "Allexperts".

There is no direct relationship between the amount of protein in urine and the need for dialysis. However, it is a sign of kidney damage and long standing proteinuria ultimately results in deterioration of kidney function.


Dr. Shah


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Dr. Shamik Shah, MD, DNB (Nephrology), ISN Fellow


I can answer all questions related to kidney diseases, hypertension, plasmapheresis and kidney transplantation. I am an Indian-Board certified Nephrologist. I was a post-Doctoral Scholar at the Division of Nephrology & Hypertension,Department of Medicine, University of California, San Diego. My area of interest is Critical care Nephrology and Acute Kidney Injury.

Please mention the units in which your lab results were reported and the normal reference range for your laboratory.

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Ten years as a Critical Care & Transplant Nephrologist

International Society of Nephrology
Indian Society of Nephrology
Indian Medical Association
European Renal Association

- Shah SH, Cerda J. Acute Tubular Necrosis; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4, pp. 191-198
- Shah SH, Cerda J. Management of Acute Kidney Injury; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4
- Cerda J, Tolwani A, Shah SH, Ronco C. Continuous Renal Replacement Therapies in Modeling and Control of Dialysis Systems edited by Azar AT, Springer-Verlag, Heidelberg, Germany (In Press)
- Shah SH, Cerda J, Kellum JA. Acute Kidney Injury in Special Circumstances. John Kellum, Jorge Cerda, eds. Renal and Metabolic Disorders, Oxford University Press (In press)
- Shah SH, Mehta RL. “Anticoagulation in CRRT: Is Citrate better?”; Vineet Nayyar Ed. Critical Care Update 2009, Jaypee Brothers (In press)
- Shah SH, Mehta RL. “Non-dialytic management of acute kidney disease”; Evidence based Nephrology, BMJ, (In press)
- Shah SH, Mehta RL. “Epidemiology of Community-acquired AKI”; Ronco C, Bellomo R, Kellum J Eds. Critical Care Nephrology, Saunders. ISBN 1-4160-4252-0
- Abdeen O, Shah SH, Mehta RL; “Dialysis therapies in the surgical intensive care unit”; William Wilson, Christopher Grande, David Hoyt Eds. Trauma: Resuscitation, Anesthesia, and Critical Care, Informa Healthcare, NY 2007. ISBN 0-8247-2920-X
- Shah SH, Mehta RL. Acute kidney injury in critical care: time for a paradigm shift? Curr Opin Nephrol Hypertens. 2006 Nov;15(6):561-5.
- Shah, SH, Soroko S, Lischer E, Mehta RL. Delivered vs. Prescribed dose of Dialysis in Hospitalized Patients: Results of an Audit. J Am Soc Nephrol 17(Abstracts Issue): 2006, 107A.
- Shah SH et al “Biochemical Nutritional Parameters in Non-vegetarian and Vegetarian CAPD patients” Perit Dial Int 2001; 21 Suppl 2: S1-182

MBBS, MD (Internal Medicine), Diplomate of National board (Nephrology), ISN Fellow

Awards and Honors
Educational Ambassador of the International Society of Nephrology 2010
Fellowship of the International Society of Nephrology 2005.
Young Investigator Award by the International Society of Peritoneal Dialysis 2001

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