A SCREENING TEST FOR MICROALBUMINURIA

MICROALBUMINURIA IS PROGNOSTIC OF DIABETIC NEPHROPATHY, A CONDITION THAT AFFECTS ABOUT 35 PERCENT OF TYPE I DIABETICS. IT IS ESTIMATED THAT THE COST OF CARE FOR UREMICDIABETIC PATIENTS WILL SOON REACH $2 BILLION A YEAR. RECENTEVIDENCE INDICATES THAT EARLY THERAPEUTIC INTERVENTION SLOWSOR HALTS THE DEVELOPMENT OF RENAL DISEASE. THE OVERALL GOAL OF THIS PROJECT IS TO STUDY THE FEASIBILITY OF DEVELOPING A RAPID, CONVENIENT, AND INEXPENSIVE TEST THAT CAN BE USED BY NONLABORATORY PERSONNELTO MEASURE LOW LEVELS OF URINARY ALBUMIN. THE TEST IS BASEDON A METHOD WHEREBY THE ALBUMIN IS FIRST IMMOBILIZED AND CONCENTRATED BY PHYSICAL ADSORPTION TO A MEMBRANE. THE IMMOBILIZED ALBUMIN IS THEN DETECTED AND QUANTITATED BY MEANS OF RELATIVELY SPECIFIC ALBUMIN-BINDING DYES. GOALS FOR THIS FEASIBILITY STUDY ARE TO IDENTIFY THE MEMBRANE AND DYE COMBINATIONS THAT WILL YIELD THE OPTIMUM RESULTS. THE USE OF IMMUNOENZYME AND/OR IMMUNOGOLD METHODS FOR DETECTING THE BOUND ALBUMIN WILL ALSO BE INVESTIGATED. WITH EITHER DETECTION SYSTEM, THE URINARY ALBUMIN CONCENTRATION WILL BE ESTIMATED BY MEASURING THE DEVELOPED COLOR, EITHER BY VISUAL COMPARISON WITH A COLOR CHART OR BY MEANS OF A REFLECTANCE PHOTOMETER. USE OF MEMBRANES TO IMMOBILIZE AND CONCENTRATE URINARY ALBUMIN PRIOR TO DETECTION AND QUANTITATION HAS NOT BEEN DESCRIBED PREVIOUSLY.