Early Stage Testing for Kidney Disease in Cats

By Malcolm Weir, DVM, MSc, MPH; Kristiina Ruotsalo, DVM, DVSc, Dip ACVP; Margo S. Tant BSc, DVM, DVSc

What is microalbuminuria?

Albumin is an important protein that is found in large quantities in the blood but is not normally present in the urine of healthy cats. The term microalbuminuria refers to the presence of very small amounts of albumin in urine.

Microalbuminuria may indicate underlying health problems and is sometimes an early warning sign of primary kidney disease (also known as renal disease).

What sorts of conditions result in microalbuminuria?

Many conditions can potentially lead to microalbuminuria. These include inflammatory conditions (e.g., dental disease, chronic skin disease, bowel inflammation, etc.), infectious disease (e.g., feline leukemia virus, feline immunodeficiency virus), metabolic disorders (e.g., diabetes mellitus, hyperthyroidism, etc.), hypertension (high blood pressure), and cancer.

What is the ERD test for microalbuminuria and when should it be used?

The early renal damage test (ERD) is a simple rapid test that detects microalbuminuria. It is a better test than the routine urine “dipstick” test (see handout “Urinalysis”) for detecting small amounts of protein in urine.

The ERD test is used when the routine urine test for protein is negative and your veterinarian wants to:

  • look further for traces of protein in the urine (e.g., in a cat at high risk for kidney disease).
  • do a comprehensive health screen to detect hidden illness in a cat.

The ERD should not be done when:

  • a routine urine test is positive for protein. In this situation, there is clearly excess protein in the urine and an ERD test will not provide any additional information. Your veterinarian may suggest doing a urine protein:creatinine ratio test, which is the best test to do when larger amounts of protein are present in the urine. See handout “Urine Protein:Creatinine Ratios” for more information on this test.
  • there are obvious signs of inflammation, infection, or bleeding in the urinary system. The large amount of inflammatory protein in the urine would give a falsely high reading on the ERD.

What sample is needed to do the ERD test for microalbuminuria?

All that is needed is a small amount of urine collected in a sterile container. The sample can be stored in the refrigerator for up to 24 hours, but your veterinarian may want to collect fresh urine from your cat for the test.


If my cat has microalbuminuria, does this mean my pet has serious kidney disease?

No. In fact, the majority of cats with microalbuminuria will not develop kidney disease.

"In most cases, treatment or management of the underlying health problem will make the microalbuminuria disappear."

In most cases, treatment or management of the underlying health problem will make the microalbuminuria disappear. It is only for a small percentage of cats that microalbuminuria is truly a warning sign of early kidney disease. These cats may go on to develop serious kidney disease and possibly kidney failure. Although a complete cure may not be possible, specific steps, such as a prescription diet and medication, can be taken to slow down the progression of the disease.

If my cat has microalbuminuria, what is the next step?

If microalbuminuria is detected, your veterinarian will likely recommend further testing to look for hidden disease. The choice of tests may vary but could include basic blood tests and urinalysis (see handouts “Complete Blood Count”, “Serum Biochemistry”, and “Urinalysis” for more information). If there is no evidence of underlying illness, then regular check-ups every 3-6 months, including ERD testing may be recommended to monitor the pet's health status and to watch any change in microalbuminuria.

Related Articles