scholarly journals Comparison of Urine Albumin-to-Creatinine Ratio (ACR) Between ACR Strip Test and Quantitative Test in Prediabetes and Diabetes

2017 ◽  
Vol 37 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Eun-Hee Nah ◽  
Seon Cho ◽  
Suyoung Kim ◽  
Han-Ik Cho
Keyword(s):  
Creatinine Ratio ◽  
Quantitative Test ◽  
Urine Albumin ◽  
Strip Test

Urine Albumin to Creatinine Ratio and Echocardiographic Left Ventricular Structure and Function in Patients with Essential Hypertension

2011 ◽  
Vol 9 (2) ◽  
pp. 90 ◽  
Author(s):  
Rohola Hemmati ◽  
Mojgan Gharipour ◽  
Hasan Shemirani ◽  
Alireza Khosravi ◽  
Elham Khosravi ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Peak Velocity ◽  
Left Ventricular ◽  
Lv Function ◽  
Creatinine Ratio ◽  
Uncomplicated Hypertension ◽  
Urine Albumin ◽  
Lv Dysfunction ◽  
Mitral Annulus Velocity ◽  
Lv Mass

Background:Appearance of microalbuminuria, particularly in patients with hypertension, might be associated with a higher prevalence of left ventricular (LV) dysfunction and geometric abnormalities. This study was undertaken to determine whether high urine albumin to creatinine ratio (UACR) as a sensitive marker for microalbuminuria can be associated with LV hypertrophy (LVH) and systolic and diastolic LV dysfunction.Methods:The study population consisted of 125 consecutive patients with essential uncomplicated hypertension. Urine albumin and creatinine concentration was determined by standard methods. LVH was defined as a LV mass index >100 g/m2 of body surface area in women and >130 g/m2 in men. Echocardiographic LV systolic and diastolic parameters were measured.Results:The prevalence of microalbuminuria in patients with essential hypertension was 5.6 %. UACR was significantly no different in patients with LVH than in patients with normal LV geometry (21.26 ± 31.55 versus 17.80 ± 24.52 mg/mmol). No significant correlation was found between UACR measurement and systolic and diastolic function parameters, including early to late diastolic peak velocity (E/A) ratio (R=-0.192, p=0.038), early diastolic peak velocity to early mitral annulus velocity (E/E') ratio (R=-0.025, p=0.794), LV ejection fraction (R=0.008, p=0.929), and LV mass (R=-0.132, p=0.154). According to the receiver operator characteristic (ROC) curve analysis, UACR measurement was not an acceptable indicator of LVH with areas under the ROC curves 0.514 (95 % confidence interval 0.394–0.634). The optimal cut-off value for UACR for predicting LVH was identified at 9.4, yielding a sensitivity of 51.6 % and a specificity of 48.3 %.Conclusion:In patients with uncomplicated essential hypertension, abnormal systolic and diastolic LV function and geometry cannot be effectively predicted by the appearance of microalbuminuria.

scholarly journals Association between Urine Albumin-to-Creatinine Ratio within the Normal Range and Incident Hypertension in Men and Women

2016 ◽  
Vol 57 (6) ◽  
pp. 1454 ◽  
Author(s):  
Dhananjay Yadav ◽  
Dae Ryong Kang ◽  
Sang-Baek Koh ◽  
Jang-Young Kim ◽  
Song Vogue Ahn
Keyword(s):  
Creatinine Ratio ◽  
Normal Range ◽  
Men And Women ◽  
Incident Hypertension ◽  
Urine Albumin

Associations of Bone Mineral Density and Bone Metabolism Indices with Urine Albumin to Creatinine Ratio in Chinese Patients with Type 2 Diabetes

2018 ◽  
Vol 6 (01) ◽  
pp. 50-55 ◽  
Author(s):  
Xin Zhao ◽  
Xiao-Mei Zhang ◽  
Ning Yuan ◽  
Xiao-Feng Yu ◽  
Li-Nong Ji
Keyword(s):  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Bone Metabolism ◽  
Early Stage ◽  
Chinese Patients ◽  
Creatinine Ratio ◽  
Mineral Density ◽  
Urine Albumin

Abstract Objective To identify correlations of bone mineral density (BMD) and bone metabolism indices with the urine albumin to creatinine ratio (ACR) as an indicator of nephropathy in Chinese patients with type 2 diabetes (T2D). Methods In this retrospective analysis, 297 patients with T2D were divided into 3 groups according to the urine ACR. Patients’ data were analyzed to identify associations of general conditions, blood glucose level, lipid levels, and uric acid level with BMD and bone metabolism indices. Results BMD at every location tested (femoral neck, trochanter, inside hip, Ward’s triangle, total hip, and lumbar vertebrae) was negatively correlated with the urine ACR (all p<0.05). Osteocalcin, beta-C-terminal telopeptide (β-CTX), and procollagen type 1 N- peptide (P1NP) were positively correlated with urine ACR (all p<0.05). Finally, 25-hydroxyvitamin D [25(OH)D] was negatively correlated with urine ACR (p<0.05). Multiple regression analysis with adjustment for age, body mass index, disease duration, and other clinical measurements revealed no significant correlation between urine ACR and BMD measurements or β-CTX (p>0.05). However, significant correlations remained between urine ACR and osteocalcin, P1NP, and 25(OH)D (p<0.05). The same results were obtained for postmenopausal women specifically, with the exception of a significant correlation between the ACR and β-CTX (p<0.05). Conclusion In the early stage of diabetic nephropathy, BMD changes and bone transformation acceleration may occur, and the acceleration of bone transformation may occur before the change in BMD. Therefore, it is important to monitor bone metabolism indices in the early stage of diabetic nephropathy in T2D patients.

scholarly journals Facility-Level Variations in Kidney Disease Care among Veterans with Diabetes and CKD

2018 ◽  
Vol 13 (12) ◽  
pp. 1842-1850 ◽  
Author(s):  
Sankar D. Navaneethan ◽  
Julia M. Akeroyd ◽  
David Ramsey ◽  
Sarah T. Ahmed ◽  
Shiva Raj Mishra ◽  
...  
Keyword(s):  
Veterans Affairs ◽  
Creatinine Ratio ◽  
Angiotensin Receptor ◽  
Urine Protein ◽  
Urine Albumin ◽  
Patients With Diabetes ◽  
Facility Level ◽  
Rate Ratios ◽  
Core Measures ◽  
Median Rate

Background and objectivesFacility-level variation has been reported among veterans receiving care for various diseases. We studied the frequency and facility-level variations of guideline-recommended practices in patients with diabetes and CKD.Design, setting, participants, & measurementsPatients with diabetes and concomitant CKD (eGFR 15–59 ml/min per 1.73 m2, measured twice, 90 days apart) receiving care in 130 facilities across the Veterans Affairs Health Care System were included (n=281,223). We studied the proportions of patients (facility-level) receiving recommended core measures and facility-level variations of these study outcomes using median rate ratios, adjusting for various patient and provider-level factors. Median rate ratio quantifies the degree to which care may vary for similar patients receiving care at two randomly chosen facilities, with <1 being no variation and >1.2 as substantial variation between the facilities. Study outcomes included measurement of urine albumin-to-creatinine ratio/urine protein-to-creatinine ratio and blood hemoglobin concentration, prescription of statins and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, BP<140/90 mm Hg, and referral to a Veterans Affairs nephrologist (only for those with eGFR<30 ml/min per 1.73 m2).ResultsAmong those with eGFR 30–59 ml/min per 1.73 m2, proportion of patients receiving recommended core measures (median and interquartile range across facilities) were 37% (22%–47%) for urine albumin-to-creatinine ratio/urine protein-to-creatinine ratio, 74% (72%–79%) for hemoglobin measurement, 66% (62%–69%) for angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prescription, 85% (74%–87%) for statin prescription, 47% (42%–53%) for achieving BP<140/90 mm Hg, and 13% (7%–16%) for meeting all outcome measures. Adjusted median rate ratios (95% confidence intervals) were 5.2 (4.1 to 6.4), 2.4 (2.1 to 2.6), 1.3 (1.2 to 1.3), 1.2 (1.2 to 1.3), 1.4 (1.3 to 1.4), and 4.1 (3.3 to 5.0), respectively. Median rate ratios were qualitatively similar in an analysis restricted to those with eGFR 15–29 ml/min per 1.73 m2.ConclusionsAmong patients with diabetes and CKD, at facility-level, ordering of laboratory tests, and scheduling of nephrology referrals in eligible patients remains suboptimal, with substantial variations across facilities.

Cystatin C and Urine Albumin to Creatinine Ratio Predict 5-Year Mortality and Cardiovascular Events in People Living With HIV

2020 ◽  
Author(s):  
Robin Chazot ◽  
Elisabeth Botelho-Nevers ◽  
Christophe Mariat ◽  
Anne Frésard ◽  
Etienne Cavalier ◽  
...  
Keyword(s):  
Cystatin C ◽  
Cardiovascular Events ◽  
Multivariable Analysis ◽  
Receiver Operating Curve ◽  
People Living With Hiv ◽  
Creatinine Ratio ◽  
Urine Albumin ◽  
All Cause Mortality ◽  
Living With Hiv

Abstract Background Identifying people with HIV (PWH) at risk for chronic kidney disease, cardiovascular events, and death is crucial. We evaluated biomarkers to predict all-cause mortality and cardiovascular events, and measured glomerular filtration rate (mGFR) slope. Methods Biomarkers were measured at enrollment. Baseline and 5-year mGFR were measured by plasma iohexol clearance. Outcomes were a composite criterion of all-cause mortality and/or cardiovascular events, and mGFR slope. Results Of 168 subjects, 146 (87.4%) had undetectable HIV load. Median follow-up was 59.1 months (interquartile range, 56.2–62.1). At baseline, mean age was 49.5 years (± 9.8) and mean mGFR 98.9 mL/min/1.73m2 (± 20.6). Seventeen deaths and 10 cardiovascular events occurred during 5-year follow-up. Baseline mGFR was not associated with mortality/cardiovascular events. In multivariable analysis, cystatin C (hazard ratio [HR], 5.978; 95% confidence interval [CI], 2.774–12.88; P &lt; .0001) and urine albumin to creatinine ratio (uACR) at inclusion (HR, 1.002; 95% CI, 1.001–1.004; P &lt; .001) were associated with mortality/cardiovascular events. Area under receiver operating curve of cystatin C was 0.67 (95% CI, .55–.79) for mortality/cardiovascular event prediction. Biomarkers were not associated with GFR slope. Conclusions uACR and cystatin C predict all-cause mortality and/or cardiovascular events in PWH independently of mGFR.

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