scholarly journals Evaluation of methods for rapid microalbuminuria screening in kidney diseased patients

2012 ◽  
Vol 140 (3-4) ◽  
pp. 173-178
Author(s):  
Marijana Dajak ◽  
Ana Bontic ◽  
Svetlana Ignjatovic ◽  
Jelena Pavlovic ◽  
Nada Majkic-Singh ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Kidney Function ◽  
Predictive Value ◽  
Kidney Diseases ◽  
Test Strip ◽  
Urine Specimen ◽  
Albumin Concentration ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Spot Urine

Introduction. One of the criteria for chronic kidney disease detection is determination of microalbuminuria. Objective. This analysis was performed to evaluate accuracy of three useful methods for microalbuminuria detection in 24h urine collection and in the morning urine specimen calculated from urine albumin creatinine ratio, or with a dipstick in patients with different kidney diseases or kidney function. Methods. Microalbuminuria was detected in 74 patients referred to the Outpatient Nephrology Department for kidney function determination or regular nephrology checking. Albumin concentration determined using immunonephelometry was lower than 300 mg/day. Discriminates cutoff values for spot urine test strip and albumin creatinin ratio in predicting 24 h protein ?threshold? excretion were determined using ROC analysis. Results. Mean value of 24 h microalbuminuria was 80.3 mg/24 h, and value >30 mg/24 h was present in 71.8% of patient. Correlation coefficients between dipstick microalbuminuria or albumin/creatinine ratio in a spot urine specimen and 24 h microalbuminuria were 0.709 and 0.598 (p<0.0001). For pathological value of 24 h microalbuminuria >30 mg/24 h, the coresponding dipstick microalbuminuria value was ?20 mg/L (AUC 0.849, specificity 95%, positive predictive value 97.3%), and ?3.55 mg albumin/mmol creatinine ratio (AUC 0.914, specificity 90% and positive predictive value 95.5%). No difference was found between dipstick mikroalbuminuria and albumin/creatinine ratio value. In addition, albumin/creatinine ratio value from 24 h urine was similar to the value obtained from the spot urine sample. Conclusion. Obtained results indicated that albuminuria could be determined accurately in spot urine either with the Micral test strip or with albumin creatinine ratio.

scholarly journals Comparison of single spot urinary albumin-creatinine ratio with 24-hour urinary protein excretion in women with preeclampsia

2018 ◽  
Vol 7 (5) ◽  
pp. 1929
Author(s):  
Indu Kaul ◽  
Bawa Ram Bhagat ◽  
Deepika Sharma ◽  
Gagan Singh
Keyword(s):  
Urine Sample ◽  
Predictive Value ◽  
Solute Concentration ◽  
Urinary Protein Excretion ◽  
Urinary Protein ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Single Spot ◽  
Spot Urine ◽  
Protein Excretion

Background: The measurement of albumin: creatinine ratio (ACR) in a spot urine sample avoids the influence of variation in urinary solute concentration and provides a more convenient and rapid method to assess protein excretion. The aim of this study was to evaluate urinary spot ACR as a new marker for proteinuria and to study its correlation and accuracy in comparison with 24-hour urinary protein.Methods: The prospective one-year study was conducted on 100 pregnant women, 18-40 years, >20 weeks gestation with a diagnosis of preeclampsia. A spot midstream urine sample was taken for detection of albuminuria by dipstick method. Another spot sample was taken for detection and calculation of spot ACR. The 24-hour urine collection was taken immediately afterward to evaluate 24-hour urinary protein excretion.Results: A positive linear relation exists between ACR and 24-hour urinary protein excretion The ROC revealed cut-off of 20.4 with 88.5% sensitivity, 75% specificity, 98.8% positive predictive value and 21.4% negative predictive value. Spot urinary ACR >20.4 correctly identified women having 24-hour urinary protein excretion in excess of 0.3 gm/DL.Conclusions: A strong correlation exists between single spot urinary ACR with 24-hour urinary protein excretion in women with preeclampsia.

Albumin excretion rate, albumin concentration, and albumin/creatinine ratio compared for screening diabetics for slight albuminuria.

1988 ◽  
Vol 34 (10) ◽  
pp. 2019-2021 ◽  
Author(s):  
A S Hutchison ◽  
D S O'Reilly ◽  
A C MacCuish
Keyword(s):  
Predictive Value ◽  
Excretion Rate ◽  
Albumin Excretion Rate ◽  
Albumin Concentration ◽  
Creatinine Ratio ◽  
Initial Screening ◽  
Negative Sample ◽  
Albumin Creatinine Ratio ◽  
Albumin Excretion

Abstract Slight albuminuria, an overnight albumin excretion rate (AER) greater than 30 micrograms/min in an "Albustix"-negative sample, predicts development of diabetic nephropathy. This study compares the AERs for 261 timed overnight urine collections with the albumin concentrations and albumin/creatinine ratios for the same specimens (equivalent to first morning specimens). Thirty-one specimens (11.9%) had AERs greater than 30 micrograms/min. Use of an albumin/creatinine ratio greater than 3.0 mg/mmol to predict an AER greater than 30 micrograms/min gave a sensitivity of 96.8%, a specificity of 93.9%, and a predictive value of 68.2%, with a correlation coefficient of 0.921. Use of an albumin concentration greater than 17 mg/L gave a sensitivity of 96.8%, a specificity of 90.9%, a predictive value of 58.8%, and a slightly poorer correlation (r = 0.904). Evidently either method is acceptable as an initial screening procedure, but determination of albumin concentration alone would be preferable because of lesser cost.

scholarly journals Is morning urinary protein-to-creatinine ratio a reliable estimator of 24-hour proteinuria in patients with kidney diseases?

2010 ◽  
Vol 138 (11-12) ◽  
pp. 726-731
Author(s):  
Visnja Lezaic ◽  
Stojanka Ristic ◽  
Violeta Dopsaj ◽  
Jelena Marinkovic
Keyword(s):  
Kidney Function ◽  
Total Protein ◽  
Kidney Diseases ◽  
Intraclass Correlation ◽  
Creatinine Ratio ◽  
Failure Group ◽  
Spot Urine ◽  
Receiver Operating Characteristic Curves ◽  
Protein Excretion ◽  
The Difference

Introduction. Proteinuria is the most frequent marker of kidney damage. Although 24-hour urinary proteinuria is the gold standard, the measurement of proteinuria from albumin urinary creatinine ratio is proposed as much useful metod. Objective. To evaluate the accuracy of urine protein-to-creatinine (P/Cr) ratio in morning urine specimens as compared with 24-hour total protein excretion for the measurement of proteinuria in patients with different kidney diseases and different renal function levels. Methods. Proteinuria in the studied patients was assessed by 24-hour protein excretion (24-hour PRT) and spot urine P/Cr ratio. The analysis of concordance between 24-hour PRT and P/ Cr was carried out using intraclass correlation coefficient (ICC), paired t-test and Bland-Altman plots. The discriminant cutoff values for spot urine P/Cr ratio in predicting 24-hour protein ?threshold? excretion were determined using receiver operating characteristic curves (ROC), as well as sensitivity and specificity. Results. A total of 303 patients were included in the study. The concordance between 24-hour PRT and P/Cr ratio was excellent (ICC 0.931). Systematic overestimation of PRT by urinary P/ Cr ratio was disclosed (mean difference 0.138, p=0.011). The P/ Cr of 0.25 (sensitivity 0.90; specificity 0.96), 0.66 (1.00; 0.91) and 2.55 (1.0; 0.97) g/g reliably predicted 24-hour urine total protein equivalent ?thresholds? at 0.2, 1.0 and 3.5 g/day. The chronic renal failure group independently positively influenced the difference between 24-hour PRT and P/Cr. It means the lower the kidney function the higher is the difference between the two proteinuria measurements. Conclusion. This study supports the recommendation of using spot urine P/Cr ratio in proteinuria screening in patients with different kidney diseases. The obtained results indicated better agreement between morning P/Cr and 24-hour PRT in patients with lower proteinuria and better kidney function.

scholarly journals Role of spot urine albumin-creatinine ratio in predicting pre-eclampsia between 20-28 weeks of gestation

2021 ◽  
Vol 8 (2) ◽  
pp. 162-165
Author(s):  
Pallavi Mahajan ◽  
Jyochnamayee Panda
Keyword(s):  
Predictive Value ◽  
Early Stage ◽  
Clinical Manifestations ◽  
Disease Process ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Spot Urine ◽  
Urine Albumin ◽  
Appropriate Treatment ◽  
Urine Albumin Creatinine Ratio

Preeclampsia is best characterized as a condition unique to pregnancy that can affect almost any organ system. Appropriate treatment can be given and its effects can be closely monitored. The only widely recognized procedure remains the 24hour urine collection. However, the protracted time involved in sample collection to final reporting in this method, renders it impractical. The current research was therefore aimed at determining the accuracy of the spot urine ratio of albumin-creatinine in asymptomatic pregnant women. Appropriate treatment if started at early stage of the disease helps in closely monitoring of the disease process.A hospital based prospective, observational study was conducted with 150 patients to establish whether a spot urine albumin-creatinine ratio measured between 20-28 weeks gestation could predict pre-eclampsia in asymptomatic pregnant woman in Department of Obstetrics and Gynecology, Kalinga Institute of Medical Sciences and PBM Hospital, Bhubaneswar between September 2018 and April 2020.Of the study group, 28 patients had high ACR value, with 25(89.3%) developed pre-eclampsia and 3(2.4%) remained normotensive whereas among 122 (81.3%) patients that were ACR negative 3 (10.7%) patients developed pre-eclampsia. ACR had a sensitivity of 89.29%, specificity 97.54%, positive predictive value of 89.29% and the negative predictive value is 97.54%.Our analysis showed that in pre-eclampsia patients, urine albumin-creatinine ratio (UACR) values were higher and UACR &#62;35.5 mg / mmol predicted pre-eclampsia well before clinical manifestations started. It is an easy, rapid and reasonably reliable method for predicting and assessing the severity of pre-eclampsia.

scholarly journals A practical approach to using spot urine protein/creatinine ratios for assessing proteinuria in pregnancy

2008 ◽  
Vol 1 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Catherine A Marnoch ◽  
Lucia Larson ◽  
Sherry Weitzen ◽  
Maureen G Phipps ◽  
C James Sung ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Spot Urine ◽  
Test Characteristics ◽  
Negative Results ◽  
Single Urine Sample ◽  
In Pregnancy

Objective: The aim of this study is to assess the diagnostic accuracy of the spot urine protein/creatinine ratio compared with the 24-hour urine protein in pregnancy. Study Design: In this prospective cohort study of inpatient pregnant women, the protein/creatinine ratio and dipstick protein were assessed from a single urine sample collected at the start of the 24-hour urine. Both tests were compared with the 24-hour urine protein for correlation and test characteristics. Results: In the 196 specimens analysed, we found a strong correlation between the spot urine protein/creatinine ratio and 24-hour urine protein ( r2 = 0.78, P < 0.01). A protein/creatinine ratio <0.1 ruled out significant proteinuria (≥300 mg/day) with sensitivity and negative predictive value 100%. A protein/creatinine ratio ≥0.4 detected significant proteinuria (specificity and positive predictive value of 100%). A protein/creatinine ratio ≥4.6 had a specificity and positive predictive value of 100% for detecting severe proteinuria (≥5000 mg/day). Urine dipsticks correlated poorly with the 24-hour urine protein ( r2 = 0.40, P = 0.826). Nineteen percent of dipsticks reading nil or trace were false-negative results. Conclusion: The spot urine protein/creatinine ratio correlated well with the 24-hour urine protein and performed better than the urine dipsticks. Significant proteinuria in pregnancy was excluded if the protein/creatinine ratio was <0.1 and identified when it was ≥0.4.

scholarly journals Association between obesity and urinary albumin-creatinine ratio in the middle-aged and elderly population of Southern and Northern China: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040214
Author(s):  
Shan Qin ◽  
Anping Wang ◽  
Shi Gu ◽  
Weiqing Wang ◽  
Zhengnan Gao ◽  
...  
Keyword(s):  
Kidney Diseases ◽  
Northern China ◽  
Cross Sectional Study ◽  
Urinary Albumin ◽  
Creatinine Ratio ◽  
Sectional Study ◽  
The South ◽  
Northern Population ◽  
Cross Sectional ◽  
Albumin Creatinine Ratio

ObjectiveThe relationship between obesity and albuminuria has not been clarified. This study aimed to investigate the correlation between obesity and the urinary albumin-creatinine ratio (UACR) in Southern and Northern China.DesignA descriptive, cross-sectional study.SettingEight regional centres in REACTION (China’s Risk Evaluation of cAncers in Chinese diabeTic Individuals, a lONgitudinal study), including Dalian, Lanzhou, Zhengzhou, Guangzhou, Guangxi, Luzhou, Shanghai and Wuhan.ParticipantsA total of 41 085 patients who were not diagnosed with chronic kidney disease (CKD) and had good compliance were selected according to the inclusion criteria. Patients who were diagnosed with CKD, who had other kidney diseases that could lead to increased urinary protein excretion, who were using angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers and whose important data were missing were excluded.ResultsParticipants with both, central and peripheral obesity, had a higher risk of elevated UACR, even after adjusting for multiple factors (OR: 1.14, 95% CI: 1.07 to 1.12, p<0.001), and the risk of high UACR in the South was more prominent than that in the North (OR South: 1.22, 95% CI: 1.11 to 1.34; OR North: 1.13, 95% CI: 1.04 to 1.22, p<0.001). The risk was also elevated in the male population, hypertensive individuals, glycosylated haemoglobin (HbA1c)≥6.5% and age ≥60 years in the South. Besides the above groups, diabetes was also a risk factor for the Northern population.ConclusionsIn China, people with both central and peripheral obesity are prone to a high UACR, and the southern population has a higher risk than northern population. Factors such as male sex, hypertension, HbA1c≥6.5% and an age ≥60 years are also risk factors for CKD.

scholarly journals Serum Carnosinase-1 and Albuminuria Rather than the CNDP1 Genotype Correlate with Urinary Carnosinase-1 in Diabetic and Nondiabetic Patients with Chronic Kidney Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Angelica Rodriguez-Niño ◽  
Sibylle J. Hauske ◽  
Anna Herold ◽  
Jiedong Qiu ◽  
Jacob van den Born ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Healthy Subjects ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Creatinine Ratio ◽  
Healthy Individuals ◽  
Albumin Creatinine Ratio ◽  
Spot Urine

Background. Carnosinase-1 (CN-1) can be detected in 24 h urine of healthy individuals and patients with type 2 diabetes (T2DM). We aimed to assess whether urinary CN-1 is also reliably measured in spot urine and investigated its association with renal function and the albumin/creatinine ratio (ACR). We also assessed associations between the CNDP1 (CTG)n genotype and CN-1 concentrations in serum and urine. Methods. Patients with T2DM (n=85) and nondiabetic patients with chronic kidney disease (CKD) (n=26) stratified by albuminuria (ACR≤300 mg/g or ACR>300 mg/g) recruited from the nephrology clinic and healthy subjects (n=24) were studied. Results. Urinary CN-1 was more frequently detected and displayed higher concentrations in patients with ACR>300 mg/g as compared to those with ACR≤300 mg/g irrespective of the baseline disease (T2DM: 554 ng/ml [IQR 212-934 ng/ml] vs. 31 ng/ml [IQR 31-63 ng/ml] (p<0.0001) and nondiabetic CKD: 197 ng/ml [IQR 112-739] vs. 31 ng/ml [IQR 31-226 ng/ml] (p=0.015)). A positive correlation between urinary CN-1 and ACR was found (r=0.68, p<0.0001). Multivariate linear regression analysis revealed that ACR and serum CN-1 concentrations but not eGFR or the CNDP1 genotype are independent predictors of urinary CN-1, explaining 47% of variation of urinary CN-1 concentrations (R2=0.47, p<0.0001). Conclusion. These results confirm and extend previous findings on urinary CN-1 concentrations, suggesting that assessment of CN-1 in spot urine is as reliable as in 24 h urine and may indicate that urinary CN-1 in macroalbuminuric patients is primarily serum-derived and not locally produced.

scholarly journals Microalbumin measurement alone or calculation of the albumin/creatinine ratio for the screening of hypertension patients?

2002 ◽  
Vol 17 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Ulla Derhaschnig ◽  
Harald Kittler ◽  
Christian Woisetschläger ◽  
Andreas Bur ◽  
Harald Herkner ◽  
...  
Keyword(s):  
Urine Sample ◽  
Diagnostic Performance ◽  
Screening Method ◽  
Creatinine Ratio ◽  
Operating Characteristics ◽  
Albumin Creatinine Ratio ◽  
Hypertensive Patients ◽  
Spot Urine ◽  
Spot Urine Sample ◽  
Receiver Operating Characteristics Curve

Abstract Background. Spot urine sampling seems to be a reliable screening method for the detection of microalbuminuria in hypertensive patients. It remains unclear whether microalbumin measurement alone or calculation of the albumin/creatinine ratio (ACR) are more reliable for the detection of microalbuminuria in non-selected hypertensive patients. Methods. Following collection of a spot, midstream urine sample, urine was collected for 24 h for the measurement of microalbumin in 264 hypertensive patients. We compared microalbumin concentration in the spot urine with microalbumin measured in the 24-h urine sample and examined the utility of the ACR in evaluating microalbuminuria in hypertensive patients. Pathologic microalbuminuria was assumed when the microalbumin concentration exceeded 30 mg/l in the 24-h urine sample. Diagnostic performance is expressed in terms of specificity, sensitivity, positive (PPV) and negative predictive value (NPV), and area under receiver operating characteristics curve (AUC). Results. A total of 47 samples (17.8%) showed pathologic microalbuminuria in the 24-h urine sample. The diagnostic performance expressed as AUC was 0.94 (95% CI 0.90–0.98) for microalbumin measurement alone and 0.94 (95% CI 0.89–0.97) for ACR. The PPV and NPV were 44.2 and 97.9% for microalbumin measurement alone. ACR revealed a PPV of 29.3% and a NPV of 96.2% for males and 42.9 and 98% for females, if a cut-off value of 2.5 mg/mmol for males and of 4.0 mg/mmol for females was used. Conclusions. The ACR did not provide any advantage compared with microalbumin measurement alone, but requires an additional determination of creatinine and the use of gender-specific cut-off values. Therefore, measurement of microalbuminuria alone in the spot urine sample is more convenient in daily clinical practice and should be used as the screening method for hypertensive patients.

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