Estimation of 24 hour urine protein excretion using urine creatinine/albumin ratio

2020 ◽  
Author(s):  
Xin Liu ◽  
Yonghong Zhao ◽  
Daqing Hong ◽  
Yunlin Feng
Keyword(s):  
General Population ◽  
Prediction Model ◽  
Quantitative Description ◽  
High Accuracy ◽  
Urine Protein ◽  
Albumin Ratio ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Urine Creatinine ◽  
Accurate Quantification

Abstract BackgroundThere is still a lack of quantitative description of the relationship between urine creatinine/albumin ratio (ACR) and 24 hour urine protein excretion (24 h UPE). We aimed to study the correlation between 24 h UPE and urine ACR and develop a prediction model for 24 h UPE.Methods This was a retrospectively observational study. All individuals with paired urine ACR and 24 h UPE tested on the same day in Sichuan Provincial People’s Hospital during September 1st, 2018 to December 31st, 2019 were enrolled. Correlation and agreement between urine ACR and 24 h UPE were evaluated. A prediction model of 24 h UPE was further developed and validated.Results 671 subjects were identified. Urine ACR had a good correlation with 24 h UPE in general population (Spearman’s coefficient = 0.939; p < 0.001) but the agreement between these two measurements was not consistently good (overall ICC = 0.870; 95% CI: 0.849–0.888; p < 0.001). Our multivariable transform model of 24 h UPE had good performance (R2 = 0.829) and validated high accuracy (RMSE = 0.0227, rRSME = 3.1%).Conclusions Urine ACR has a good correlation with 24 h UPE in general population but is not a reliable surrogate for 24 h UPE. Our prediction model is a useful tool for estimating 24 h UPE, however, 24 h UPE is still mandatory in situations when accurate quantification of proteinuria is required.Key messages:1. urine ACR has a good correlation with 24h UPE but is not a reliable surrogate for 24h UPE.2. Our prediction model is helpful to estimate 24h UPE, with good performance (R2=0.829) and validated high accuracy (RMSE=0.0227, rRSME=3.1%); however, 24h UPE is still mandatory in situations when accurate quantification of proteinuria is required.

scholarly journals Estimation of 24-hour urine protein excretion using urine albumin-to-creatinine ratio

2020 ◽  
Author(s):  
Xin Liu ◽  
Yonghong Zhao ◽  
Daqing Hong ◽  
Yunlin Feng
Keyword(s):  
Prediction Model ◽  
Quantitative Description ◽  
High Accuracy ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Natural Logarithm ◽  
Urine Albumin ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
The Relationship

Abstract Background There is still a lack of quantitative description of the relationship between urine albumin-to-creatinine ratio (ACR) and 24-hour urine protein excretion (24h UPE). We aimed to study the correlation between 24h UPE and urine ACR and develop a prediction model for 24h UPE employing urine ACR. Methods This was a retrospective and observational study. All individuals with same-day urine ACR and 24h UPE tests in Sichuan Provincial People’s Hospital from September 1, 2018 to December 31, 2019 were enrolled in the study. Correlation and agreement between urine ACR and 24h UPE were evaluated. A prediction model of 24h UPE was developed and validated. Results 671 subjects were identified. Urine ACR correlated well with 24h UPE (Pearson’s coefficient after natural logarithm transformation = 0.908; p<0.001) and the agreement was consistently good (overall ICC = 0.938; 95% CI: 0.928-0.947; p<0.001). Our multivariable transform model had good performance (R 2 =0.869) and high accuracy (RMSE=0.690) to estimate 24h UPE less than 10 g/day. Conclusions Urine ACR correlates well with 24h UPE in a general population. Our prediction model is an useful tool for estimating 24h UPE less than 10 g/day, however, 24h UPE is still mandatory in situation when the majority of proteinuria is of tubular origin.

scholarly journals Hormone therapy and urine protein excretion

2018 ◽  
Vol 25 (6) ◽  
pp. 625-634 ◽  
Author(s):  
Andrea G. Kattah ◽  
Maria L.G. Suarez ◽  
Natasa Milic ◽  
Kejal Kantarci ◽  
Burcu Zeydan ◽  
...  
Keyword(s):  
Hormone Therapy ◽  
Urine Protein ◽  
Urine Protein Excretion ◽  
Protein Excretion

Abstract 171: Improving Adherence to Antihypertensive Agents for Hypertensive Patient With Chronic Kidney Disease

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Yunyun Li ◽  
Xianghong Zeng ◽  
Xiangji Zeng ◽  
Jiangyuan Xie
Keyword(s):  
Blood Pressure ◽  
Treatment Group ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Antihypertensive Agents ◽  
Renal Dialysis ◽  
Medication Possession Ratio ◽  
Urine Protein ◽  
Urine Protein Excretion ◽  
Protein Excretion

Background: hypertension is a modifiable and very important risk factor in chronic renal disease (CKD), and medication adherence (MA) is critical in reaching the treatment goals. Improvement of MA for antihypertensive agents and its impact on blood pressure (BP) in CKD practice settings are not well studied. Methods: In a prospective, controlled open-label studies, the authors have evaluated the four year MA for antihypertensive agents on progress of renal disease and risk of development of cardiovascular disease in 546 hypertension patients with CKD from 2006 to 2014 with targeted nurse-physician intervention. Before randomization Outpatient BP measurements were averaged as high (>140/ 90 mm Hg) . Blood pressure ,serum creatinine(Cr) and potassium were monitored every 14 days in the period of follow-up by physician and healthcare nurse so that every patient is able to perforce self-monitoring BP at home and medication possession ratio(MPR) of target systolic blood pressure<130/80 mmHg is more than 90 % in observation groups. MA was calculated using medication possession ratio (MPR = actual treatment days/total possible treatment days). Good versus Poor MA (MPR ≥ 0.9 vs. <0.9) groups were compared for differences in outcome and laboratory variables. Results: By the end of four year,MPR in observation group is 94% and in other is 38%, mean blood pressure in good MA group was 126/76±9/7 mmHg and in control was 146/88±19/12 mmHg, Cr clearance increased from 51±2.0 to 64±3.0 ml/min (p<0.001)in the group of good MA group, By contrast, Cr clearance decreased significantly from 52±1.9 to 40±3.6 ml/min( P<0.001)in the controls. During this time, urine protein excretion decreased from 1.4±0.5 to 0.7±0.4g every 24 hours(P<0.0001) in the treatment group ,but urine protein excretion decreased slightly (from 1.3±0.4 to 1.2±0.6,P>0.05)in the controls. 20 patients had got ACS ,28 patients stroke,38 patients had got pneumonia, 11 patients renal dialysis and nine patient died (6 in SCD and 2 in heart failure and 1 in pneumonia) in controls ,but six patient had stroke ,11 pneumonia, 3 patient renal dialysis and four patients died (2 in SCD and 2 in non-cardio causes) in the treatment group, but incidence of hyperkalaemia was similar between two groups. Conclusions: Good MA is associated with a greater controlled hypertension, better protection of heart and kidney and may decrease mortality than the poor MA.

scholarly journals To evaluate the diagnostic value of protein: creatinine ratio in a single voided urine sample for quantitation of proteinuria compared to those of a 24-hour urine sample in patients with preeclampsia

2014 ◽  
Vol 9 (2) ◽  
pp. 45-53
Author(s):  
S Hossain ◽  
A Ghosh ◽  
A Chatterjee ◽  
G Sarkar ◽  
SS Mondal
Keyword(s):  
Urine Sample ◽  
Gold Standard ◽  
Diagnostic Value ◽  
Standard Test ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Predictive Values ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Gold Standard Test

Objective: This study was done to evaluate the diagnostic value of protein: creatinine ratio in a single voided urine sample for quantitation of proteinuria compared to those of a 24 hour urine sample in patients with preeclampsia. Methods: A prospective simple random sample study was done on the hypertensive pregnant women attending the antenatal clinic or admitted in Department of Obstetrics and Gynaecology. It included all women being evaluated for preeclampsia, regardless of the alerting sign or symptom, suspected severity or co-morbid conditions. The main measures were the urinary protein to urinary creatinine ratio by random (spot) direct measurement and the 24-h urinary protein excretion by a 24-h urine collection. The data obtained was statistically analyzed. Results: Out of the 78 patients with gestational hypertension included in our study 48 patients had significant proteinuria (e”300mg/day). Only 2 patients had proteinuria of the range of greater than 3500mg. Among the patients, 50 had a positive protein: creatinine ratio (e”0.3) while 28 patients had a negative protein: creatinine ratio (<0.3). The P: C ratio was able to correctly identify 44 out of 48 patients with significant proteinuria (when the comparison is made with the gold-standard test; i.e., 24-hour urine protein). It could also identify 24 out of 30 patients without significant proteinuria as compared to the gold-standard test. In this study, the Protein: Creatinine ratio with a sensitivity of 91.67%, a specificity of 80%, positive predictive values 88% and the negative predictive values 85.71%. Conclusions: Our data suggests that the protein: creatinine ratio in single voided urine is a highly accurate test (p value < 0.0000001) for discriminating between insignificant and significant proteinuria. Based on the above findings we conclude that a random urine protein excretion predicts the amount of 24- hour urine protein excretion with high accuracy. This could be a reasonable alternative to the 24-hour urine collection for detection of significant proteinuria in hospitalised pregnant women with suspected preeclampsia. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 45-53 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9687

Treatment of Relapsed Myeloma in a Patient With Renal Insufficiency

2018 ◽  
Vol 36 (20) ◽  
pp. 2012-2016
Author(s):  
Joan Bladé ◽  
Laura Rosiñol ◽  
María Teresa Cibeira ◽  
Carlos Fernández de Larrea
Keyword(s):  
Serum Creatinine ◽  
Light Chain ◽  
Progressive Disease ◽  
M Protein ◽  
Bone Lesions ◽  
High Dose ◽  
Kappa Light Chain ◽  
Urine Protein ◽  
Urine Protein Excretion ◽  
Protein Excretion

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 45-year-old man was diagnosed in March 2010 with stage III immunoglobulin G kappa multiple myeloma (MM) after presenting with bone pain as a result of multiple lytic bone lesions and T12 vertebral collapse. Laboratory work-up showed a serum M protein of 72 g/L and a 24-hour kappa light-chain urine protein excretion of 730 mg, hemoglobin of 10.2 g/dL, serum albumin of 49 g/L, serum β2-microglobulin of 6.4 mg/L, serum creatinine level of 1.6 mg/dL with an estimated glomerular filtration rate (eGFR) of 47 mL/min/1.73 m2, and normal serum calcium and lactate dehydrogenase (LDH) levels. His bone marrow contained 58% plasma cells, which showed the 17p deletion abnormality (Fig 1). He was treated with vertebroplasty and alternating chemotherapy with carmustine, vincristine, cyclophosphamide, melphalan, and prednisone and vincristine, carmustine, doxorubicin and dexamethasone. Because of progressive disease, salvage therapy with bortezomib and dexamethasone was administered with no response. The patient was then switched to lenalidomide and dexamethasone, which yielded minimal response. He underwent autologous stem-cell transplantation (ASCT) with melphalan 200 mg/m2 as high-dose therapy in February 2011, which led to a partial response, but in December 2011, progressive disease was documented, and the patient was enrolled in a clinical trial of carfilzomib monotherapy, with stable disease for 33 cycles. In October 2014 serum M protein rose to 38.6 g/L, with 24-hour kappa light-chain urine protein excretion of 840 mg, serum creatinine of 2.1 mg/dL, and an eGFR of 41 mL/min/1.73 m2. He presented to discuss ongoing treatment options.

Assessment of possible nephrotoxicity from iohexol in patients with normal and impaired renal function

1998 ◽  
Vol 39 (4) ◽  
pp. 362-367 ◽  
Author(s):  
S. Lundqvist ◽  
G. Holmberg ◽  
G. Jakobsson ◽  
F. Lithner ◽  
K. Skinningsrud ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Renal Function ◽  
Adverse Events ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Impaired Renal Function ◽  
Urine Protein ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Patients With Diabetes

Purpose: To evaluate the possible nephrotoxic effects of iohexol in patients with normal and impaired renal function. Material and Methods: A prospective urographic study using iohexol (50 ml, 300 mg I/ml) was performed in 100 patients, 63 with impaired renal function (IRF) and 37 with normal renal function (NRF). The group included 24 patients with diabetes mellitus, 17 of them with IRF. Renal function parameters and adverse events were recorded for one week after the urography. Results: There were no significant changes in serum creatinine, creatinine clearance, or β-2-microglobulin. The 24-h urine protein excretion showed a statistically significant increase in patients with NRF as well as in patients with IRF. Nine patients experienced adverse events but none of them required any treatment. Conclusion: Iohexol was tolerated well in patients with NRF and in patients with IRF without significant overall nephrotoxic effects. Some minor adverse events were recorded.

Sign in / Sign up

Export Citation Format

Share Document