Advertisement

An Evidence-Based Practice Protocol for the Diagnosis and Management of Microalbuminuria in the Diabetic Patient

  • Author Footnotes
    1 Janyce Agruss, DNSc, APN/CNP, is coordinator of the Family Nurse Practitioner Program at Rush University Medical Center along with Martha Siomos, ND, RNC, MS, BC-ADM, APN/FNP.
    Janyce Agruss
    Footnotes
    1 Janyce Agruss, DNSc, APN/CNP, is coordinator of the Family Nurse Practitioner Program at Rush University Medical Center along with Martha Siomos, ND, RNC, MS, BC-ADM, APN/FNP.
    Search for articles by this author
  • George Bakris
    Search for articles by this author
  • Author Footnotes
    2 Theresa Gruskovak-Hernandez, MSN, APN/CNP-C, at Rush University Medical Center.
    Theresa Gruskovak-Hernandez
    Footnotes
    2 Theresa Gruskovak-Hernandez, MSN, APN/CNP-C, at Rush University Medical Center.
    Search for articles by this author
  • Author Footnotes
    1 Janyce Agruss, DNSc, APN/CNP, is coordinator of the Family Nurse Practitioner Program at Rush University Medical Center along with Martha Siomos, ND, RNC, MS, BC-ADM, APN/FNP.
    Martha Siomos
    Footnotes
    1 Janyce Agruss, DNSc, APN/CNP, is coordinator of the Family Nurse Practitioner Program at Rush University Medical Center along with Martha Siomos, ND, RNC, MS, BC-ADM, APN/FNP.
    Search for articles by this author
  • Author Footnotes
    1 Janyce Agruss, DNSc, APN/CNP, is coordinator of the Family Nurse Practitioner Program at Rush University Medical Center along with Martha Siomos, ND, RNC, MS, BC-ADM, APN/FNP.
    2 Theresa Gruskovak-Hernandez, MSN, APN/CNP-C, at Rush University Medical Center.

      Abstract

      Diabetes is the single most common cause of end-stage renal disease in the United States and Europe. Advanced practice nurses have the tools to review research and make clinical practice changes based on that evidence to provide effective quality care to their diabetic patients. Knowledge of microalbuminuria, how to screen for it, diagnose it, and manage it, are all a part of the advance practice nurse's role in diabetes management. This article is an office-specific protocol that can be used by all health care providers and includes algorithms for the screening and management of microalbuminuria in diabetic patients.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal for Nurse Practitioners
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Standards of medical care in diabetes: nephropathy screening and treatment.
        (Accessed May 17, 2005.)
        • Gerstein H
        • Mann J
        • Yi Q
        • et al.
        Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals.
        JAMA. 2001; 286: 421-426
        • Gerstein HC
        • Mann JFE
        • Pogue J
        • et al.
        Prevalence and determinants of microalbuminuria in high-risk diabetic and nondiabetic patients in the Heart Outcomes Prevention Evaluation Study.
        Diabetes Care. 2000; 23: B35-B39
        • Tapp RJ
        • Shaw JE
        • Zimmet PZ
        • et al.
        Albuminuria is evident in the early stages of diabetes onset: results from the Australian Diabetes, Obesity, and Lifestyle study.
        Am J Kidney Dis. 2004; 44: 792-798
        • Donnelly R
        • Yeung JMC
        • Manning G
        Microalbuminuria: a common, independent cardiovascular risk factor, especially but not exclusively in type 2 diabetes.
        J Hypertens. 2003; 21: S7-S12
      2. Standards of medical care in diabetes: nephropathy screening and treatmenta.
        (Accessed January 30, 2006.)
        • Ehrmeyer S
        Using a creatinine ratio in urinalysis to improve the reliability of protein and albumin results. Clin Issues. 2003.
        (Accessed July 26, 2005.)
        • Armor BL
        Diabetes mellitus non-glucose monitoring: point of care testing.
        Ann Pharmacother. 2004; 38 (Accessed July 26, 2005.)
      3. Microalbumin and microalbumin/creatinine ratio.
        (Accessed August 1, 2005.)
        • Arcangelo VP
        • Peterson AM
        Pharmacotherapeutics for advanced practice: a practical approach. Lippincott Williams & Wilkins, Philadelphia, Pa2001
        • Mogensen CE
        • Neldam S
        • Tikkanen I
        • et al.
        Randomized controlled trial of dual blockade of rennin-angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: the Candesartan And Lisinopril Microalbuminuria (CALM) study.
        Br Med J. 2000; 321: 1440-1444
        • Ruggenti P
        • Fassi A
        • Ilieva AP
        • et al.
        Preventing microalbuminuria in type 2 diabetes.
        N Engl J Med. 2004; 351: 1941-1951
        • Lovel HG
        Angiotensin converting enzyme inhibitors in normotensive diabetic patients with microalbuminuria.
        Cochrane Database Syst Rev. 2005; (Accessed November 15. 2005.): 4
        • Glanz K
        • Rimer BK
        • Lewis FM
        Health behavior and health education: theory, research, and practice. 3rd ed. Jossey-Bass, San Francisco, Calif2002: 67-76
        • Donabedian A
        The quality of care: how can it be assessed?.
        JAMA. 1988; 260: 1743-1748
        • Bourlware LE
        • Jaar BG
        • Tarver-Caar ME
        • Brancati FL
        • Powe NR
        Screening for proteinuria in US adults: a cost effectiveness analysis.
        JAMA. 2003; 290: 3101-3114