Obtaining immediate results makes testing for albuminuria at the point of care far superior to central laboratory assays. Here we determined if a quantitative desk-top system could identify and monitor patients with microalbuminuria. Urinary albumin excretion was measured in 259 patients of a population cohort study where they collected 24-h urines and first morning void samples prior to three clinic visits at three week intervals. The albumin concentration was determined with both an in-office HemoCue Albumin 201 system and a central laboratory BNII nephelometer. The median (interquartile-range) urinary albumin concentration in the first morning void, intra-individual variability in patients excreting more than 30 mg/day and the prediction of microalbuminuria in subsequent 24-h collections measured by each technique were statistically indistinguishable. The HemoCue system met the FDA criterion for precision while being at its border for accuracy. Our study shows that determination of urinary albumin concentration in a first morning void by the HemoCue point-of-care system provides a good alternative to central laboratory analysis identifying and monitoring patients with microalbuminuria.