Weekend old friends gathering, everyone is very happy, but only Xiao Zhang face with a sad face. When asked, Zhang said that he had a lot of foam in his urine (not in the past) and had been worried. He went to the hospital for a physical examination and there was nothing abnormal, but then the doctor asked him to check the urine microalbumin and found that the urine microalbumin was very high, so he was worried that there was something wrong with his kidneys, so his face was full of worry. What is microalbuminuria? How is it formed? Does it have any significance? Do I need to treat it? How to prevent it? These questions are both the concerns of Xiao Zhang and the confusion of many people. Under normal human metabolism, there is very little albumin in the urine, specifically no more than 20 mg per liter of urine albumin. Urine albumin content in the range of 20mg/L- 200mg/L, routine urine tests, protein characterization is negative, it belongs to microalbuminuria. If the amount of albumin in the urine exceeds 200mg/L, the urinalysis is positive and the degree of protein characterization can vary from “+” to ” ++++”, then it is not microalbuminuria but clinical proteinuria. As we all know, positive urine routine protein means kidney damage, and it can be very serious damage, because positive urine protein means irreversible kidney damage, and sometimes it can progress very fast, even to uremia. So what does the presence of microalbuminuria (negative urine protein) mean? Microalbuminuria is a sign of changes in the entire vascular system and can be considered a “window” to arterial disease. Arteries are distributed throughout the body and the earliest indication of intimal lesions is the presence of microalbuminuria. The main functional unit of urine filtration by the kidney is the renal unit, which is composed of a ball of tiny arteries. After intimal injury, a series of pathophysiological changes in the body lead to an increase in the amount of albumin leaked from the kidneys, and when it exceeds 20mg/L, it enters the era of “micro”, and when it exceeds 200mg/L, it enters the “fast track” of clinical proteinuria with irreversible damage. The “fast track”. Microalbuminuria is an early indication of changes in the kidney and cardiovascular system. Since “early” means reversible, microalbuminuria is considered the only “window” in the process of kidney disease that can be reversed, and has attracted a lot of attention from clinicians. The appearance of microalbuminuria is often thought of in the following situations: in the case of diabetic patients, the appearance of microalbuminuria indicates the development of diabetic complications, including nephropathy, cardiovascular disease, neuropathy, etc., and is closely related to the prognosis of diabetes and insulin resistance; in the case of hypertensive patients, the appearance of microalbuminuria means kidney damage, which in turn indicates a higher risk of stroke In the case of patients with cardiovascular disease, the mortality rate of cardiovascular events in patients with positive microalbuminuria is 2 to 8 times higher than in negative patients; if microalbuminuria is found for the first time and there are no diseases like those mentioned earlier, it means the occurrence of kidney disease and the detection of microalbuminuria has been used as a routine screening indicator for kidney damage. Or conversely, once microalbuminuria is positive, one must be aware of the possibility of diabetes, hypertension, kidney disease, cardiovascular disease, etc. Since microalbuminuria is so important, is there any good way to treat it? Most of the people with clinical onset have characteristics such as around middle age, abdominal obesity, low activity, irregular life, or with diabetes, hypertension and other diseases. Most of these patients have insulin resistance. Microalbuminuria is closely related to the state of insulin resistance, and the latter is the core of causing diabetes, hypertension, obesity and other diseases. Therefore, improving the insulin resistance status should be the main means to reduce microalbuminuria. Unfortunately, Western medicine currently has a relatively single approach to treating microalbuminuria, or controlling insulin resistance. The currently recognized and widely used approach is the use of two classes of antihypertensive drugs, namely angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists, which can reduce urinary microalbumin excretion, but cannot improve the insulin resistance state well. In addition, drugs that can improve insulin resistance include metformin and rosiglitazone, the use of the former in non-diabetic populations is questionable and the latter is limited due to its cardiovascular side effects. Therefore, the clinical approach of Western medicine is limited. A combination of Western and Chinese medicine has been used to treat microalbuminuria with good efficacy, not only to control the amount of urinary microalbumin well, but also to improve the insulin resistance status. Through research, we found that the occurrence of microalbuminuria is related to the weakness of spleen qi and the interconnection of phlegm and stasis, which is clinically in line with the theory of “aggregation” in Chinese medicine. Through the “Yi Qi Dispersal Formula” (empirical formula) and basic treatment, we not only resolved the insulin resistance and fundamentally cleared the upstream root cause of microalbuminuria, but also reduced endothelial damage by lowering microalbuminuria, thus preventing the occurrence and progression of related disease complications downstream and better protecting the kidney. . In addition to the above treatment, attention should be paid to regular testing of urinary microalbumin, which should be done once a year for the general population and every 3 months for patients who have increased. In this way, it plays a positive role in the prevention and early treatment of kidney disease. In conclusion, we should pay attention to microalbuminuria in order to better prevent complications of related diseases and better protect the kidneys.