What is stage 2 Chronic Kidney Disease (CKD) with microalbuminuria?

Understanding Stage 2 CKD with Microalbuminuria

Stage 2 Chronic Kidney Disease (CKD) with microalbuminuria is a condition where your kidneys are showing early signs of damage through protein leakage in urine, while still maintaining relatively good filtering function with an eGFR between 60-89 mL/min/1.73m².

What is Stage 2 CKD?

• Stage 2 CKD is defined by evidence of kidney damage (usually albuminuria) with an estimated glomerular filtration rate (eGFR) between 60-89 mL/min/1.73m² 1
• At this stage, your kidneys are still functioning relatively well but show early signs of damage 1
• CKD staging helps doctors determine the appropriate focus of kidney-related care, which for Stage 2 includes diagnosing the cause of kidney injury and evaluating/treating risk factors 1

What is Microalbuminuria?

• Microalbuminuria (now called "moderately increased albuminuria") is defined as having 30-300 mg/g of albumin in your urine when measured by the urine albumin-to-creatinine ratio (UACR) 1
• It represents an early sign of kidney damage and vascular dysfunction 2
• To confirm microalbuminuria, two of three urine specimens collected over a 3-6 month period should show elevated levels 1

How is it Detected?

• Screening is typically done using a random spot urine test to measure the albumin-to-creatinine ratio (UACR) 1
• Normal UACR is less than 30 mg/g creatinine, while microalbuminuria is defined as 30-300 mg/g creatinine 1
• 24-hour urine collections are more burdensome and add little to prediction or accuracy 1
• For patients with diabetes, regular screening for microalbuminuria is recommended 3

What Causes Stage 2 CKD with Microalbuminuria?

• Diabetes is one of the leading causes, accounting for 20-40% of CKD cases 1, 3
• Hypertension is another significant cause 3
• Other causes include glomerulonephritis and certain genetic conditions 3
• For diabetic patients, CKD typically develops after 10 years in type 1 diabetes but may be present at diagnosis in type 2 diabetes 1, 3

What Does This Mean for Your Health?

• Microalbuminuria is an important predictor of both kidney disease progression and cardiovascular disease 4, 2
• Even at this early stage, the presence of microalbuminuria significantly increases your risk for future kidney problems and heart disease 5
• The combination of reduced eGFR and albuminuria provides better prediction of risk than either measure alone 1
• Stage 2 CKD with microalbuminuria requires attention to prevent progression to more advanced stages 1

Treatment Focus

• At Stage 2 CKD, the focus is on diagnosing the cause of kidney injury and treating risk factors 1
• Managing blood pressure and blood sugar (if diabetic) is crucial 3
• Medications like ACE inhibitors or ARBs may be recommended to reduce albuminuria and protect kidney function 3
• Regular monitoring of kidney function through eGFR and UACR tests is important 1
• Lifestyle modifications including dietary changes, exercise, and avoiding kidney-damaging medications are recommended 1

Important Considerations

• Microalbuminuria can sometimes be temporarily elevated due to fever, exercise, urinary tract infections, or certain medications 1
• Cardiovascular and kidney risk is elevated even in the high normal range of microalbuminuria (below 30 mg/day) 2
• Early detection and treatment can significantly slow progression of kidney disease 5
• Regular follow-up with healthcare providers is essential for monitoring kidney function 1

When to Seek Additional Care

• If your albuminuria levels continue to increase despite treatment 3
• If your eGFR begins to decline rapidly 3
• If you develop symptoms such as swelling in your legs, fatigue, or changes in urination patterns 1
• If you have diabetes with microalbuminuria, more frequent monitoring may be needed 1