ALB and diabetic kidney disease: However, microalbumin urine is not a sensitive and specific predictor for prevalence and progression of DKD, as the sensitivity and specificity of microalbuminuria for early detection of disease are limited by a number of factors: high day-to-day variability of urine albumin excretion; the phenomenon of non-albuminuric diabetic nephropathy; and presence of advanced renal pathological changes by the time microalbuminuria is clinically detectable [9].