Richard K. Bernstein, MD, FACE, CWS, of the Diabetes Center in Mamaroneck, New York, rountinely uses the 24-hour urine test to check for microalbuminuria, as well as creatinine clearance (CR CL), which measures the glomerular filtration rate or total kidney function..
“To measure creatinine clearance, a lab requires not just a 24-hour urine sample, but also a few ccs of blood since the serum creatinine must also be measured,” says Bernstein. Multiple tests over a period of time will allow a physician to track the creatinine clearance rate and catch any early signs of kidney disease. Bernstein adds that diabetic kidney diseases is also associated with an elevated serum fibrinogen level. Therefore, he routinely tracks serum fibrinogen at least annually, even in people who have not yet had abnormal tests of their 24-hour urine.
“We find that when [diabetic kidney disease] or elevated serum fibrinogen is caught early, we can reverse the condition with normalization of blood sugar.”