Previous studies by our group have shown that albumin is metabolized in rodents during renal passage and excreted in the urine as a mixture of intact protein and albumin-derived fragments. The aim of this study was to examine whether albumin is metabolized during renal passage in nondiabetic volunteers and in type 1 diabetic patients with varying levels of albuminuria. Nine nondiabetic normoalbuminuric volunteers and 11 type 1 diabetic patients with albumin excretion rates varying from normoalbuminuria to macroalbuminuria were studied. Each subject received an intravenous injection of tritium-labeled albumin ([ 3 H]-albumin). Urine was collected at 4 h and 24 h after injection and analyzed by size exclusion chromatography. The amount of intact and fragmented albumin was quantified, and each fraction was analyzed by radioimmunoassay (RIA) for albumin. [ 3 H]-albumin in nondiabetic volunteers was metabolized during renal passage to small peptide fragments not detectable by conventional RIA (only 0.05-3.8% of the total urinary radioactivity was associated with intact albumin). The process responsible for albumin fragmentation was similar in diabetic patients with normoalbuminuria (intact albumin represented 0.01-4.0% of total urinary radioactivity). However, there was a reduction in the fragmentation ratio (fragmented:intact) in diabetic patients with micro-or macroalbuminuria (intact albumin represented 2.7-55.5%, P = 0.048). This change in the fragmentation ratio was directly related to the degree of albuminuria. These results have important implications for understanding the mechanisms underlying albuminuria in nondiabetic volunteers and type 1 diabetic patients. In nondiabetic volunteers, the renal processing of albumin involves a relatively rapid and comprehensive degradation of albumin to small fragments (range 1-15 kDa). The degradation process is inhibited in diabetic nephropathy in proportion to the level of albuminuria detected by RIA. Diabetes 49:1579-1584, 2000 M icroalbuminuria, as measured by radioimmunoassay (RIA), is generally equated with the development of diabetic nephropathy in type 1 diabetes (1,2). The change in albumin excretion rate (AER) has traditionally been explained as being due to changes in the glomerular permselectivity barrier and intraglomerular pressure (3,4) with the assumption that albumin remains intact during filtration and renal passage. However, recent studies by our group using tritium-labeled albumin ([ 3 H]-albumin) in a rodent model have demonstrated that albumin excretion could be significantly influenced by the metabolism of albumin to small peptide fragments during its renal passage (5-9). The fragmentation is extensive, with 90-95% of the urinary albumin representing a complex fragment population of >30 different fragments with molecular weights in the range of 1-15 kDa. These albumin-derived fragments are not detected by standard immunochemical assays (6,8). A small number of studies have previously identified albumin fragments in human urine, although the source of...