scholarly journals A Prospective Study of Urinary Albumin to Creatinine Ratio and Its Associated Causes

2021 ◽  
pp. 206-210
Author(s):  
Jayamathi Govindaraj ◽  
U. Vidhya Rekha ◽  
Keerthidaa Govindaraj ◽  
S. Bhuminathan
Keyword(s):  
Urinary Albumin ◽  
Creatinine Ratio ◽  
Predictive Values ◽  
Urine Albumin ◽  
Normal Ranges ◽  
All Cause Mortality ◽  
A Prospective Study ◽  
Filtration Capacity ◽  
Reduced Risk

Urine albumin-to-creatinine ratio have predictive values for hypertension, diabetes mellitus, renal dysfunction etc. Albumin-to-creatinine ratio represents the severity of proteinuria,  indicates high probability of damage to glomerular filtration capacity of the kidney and is of great diagnostic relevance. Emerging data suggested that reduction of albuminuria leads to reduced risk of adverse renal and cardiovascular events but also steps should be taken to suppress albuminuria to prevent future renal and cardiovascular adverse events. This review discusses the association between albuminuria and adverse cardiovascular and renal outcomes in type 2 diabetes and hypertension. This study aimed to review the association between normal ranges of urine albumin-to-creatinine ratio to cardiovascular and all-cause mortality.

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.

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.

scholarly journals Assessing the Clinical Utility of Haptoglobin to Creatinine Ratio as a Test for Detecting Nephropathy among Type 2 Diabetic Patients

2019 ◽  
Vol 2 (3) ◽  
pp. 180-184
Author(s):  
IY Mohammed ◽  
AO Busari ◽  
MB Ahmad
Keyword(s):  
Quantitative Determination ◽  
Regression Model ◽  
Clinical Utility ◽  
Diabetic Patients ◽  
Creatinine Ratio ◽  
Type 2 Diabetic Patients ◽  
Urine Albumin ◽  
Type 2 Diabetic

Diabetic nephropathy is the leading cause of diabetic complications and end-stage renal disease worldwide, especially in Nigeria. This study assessed the clinical utility of urine Albumin to Creatinine ratio (UACR) and urine Haptoglobin to Creatinine ratio (UHCR) in detecting nephropathy among type 2 diabetic patients attending Aminu Kano Teaching Hospital. Eighty (80) type 2 diabetic patients attending Aminu Kano Teaching Hospital were recruited for this study after excluding those with overt proteinuria. Blood sample was collected for quantitative determination of serum creatinine using Jaffe's method while the Urine sample was received for quantitative determination of urine albumin and urine haptoglobin levels. Linear regression model revealed a unit change in urine albumin to creatinine ratio (UACR) and urine haptoglobin to creatinine ratio (UHCR) with a significant reduction in estimated Glomerular Filtration Rate (eGFR) by 2.197ml/min and 27.969 ml/min respectively (p<0.05) when used while logistic regression model demonstrated that UHCR have 91.7% sensitivity, 95% specificity, 98% positive predictive value and 79% negative predictive compared to UACR with 83.3% sensitivity, 75% specificity, 91% positive predictive and 60% negative predictive. Based on these findings, UHCR is a good marker for detecting nephropathy in diabetic patients.

scholarly journals Dapagliflozin, as Add-on Therapy in Type 2 Diabetes Patients, Is Associated With a Reduction in Albuminuria and Serum Transaminase Levels

2021 ◽  
Vol 2 ◽  
Author(s):  
Silas Benjamin ◽  
Manjunath Ramanjaneya ◽  
Alexandra E. Butler ◽  
Imran Janjua ◽  
Firjeeth Paramba ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Glycosylated Hemoglobin ◽  
Group Analysis ◽  
Serum Transaminase ◽  
Hypoglycemic Agents ◽  
Combination Group ◽  
Creatinine Ratio ◽  
Urine Albumin

IntroductionSGLT-2 inhibitors are shown to be nephroprotective, slowing progression of nonalcoholic steatohepatitis (NASH) in addition to improving glycemic control in patients with type 2 diabetes (T2D). To date, no real-life clinical data is available on the effect of SGLT-2 inhibitors on urine albumin-creatinine ratio (ACR) and liver enzymes in a Middle Eastern population. Therefore, we evaluated the effect of dapagliflozin (DAPA) on urine ACR, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) when added to standard therapy for T2D.MethodsThis is an observational study of 40 patients with T2D in whom DAPA was added to their existing anti-diabetic regimen to improve glycemic control. The primary outcomes were changes in serum transaminase level and urine albumin-to-creatinine ratio (ACR). Secondary outcomes include changes in glycosylated hemoglobin (HbA1C), body mass index (BMI), oral hypoglycemic agents and insulin dose.ResultsWhole group analysis showed a reduction in ALT (p&lt;0.0001), (AST) (p=0.009), ACR (p=0.009) and BMI (p&lt;0.0001) following DAPA treatment. Further sub-group analysis showed that patients on insulin and DAPA combination had a reduction in ACR (p=0.0090), ALT (p=0.0312), BMI (p=0.0007) and HbA1c (p&lt;0.0001) compared to the sulfonylurea and DAPA combination group. In the sulfonylurea and DAPA combination group, there was a reduction in the sulfonylurea requirement following DAPA therapy (p=0.0116), with reductions in ALT (p=0.0122), AST (p=0.0362), BMI (p=0.0026) and HbA1c (p&lt;0.0001) but with no change in ACR (p=0.814).ConclusionIn routine clinical practice, the addition of DAPA to standard medical therapy is well tolerated and beneficial for T2D patients and is associated with a reduction of ALT and ACR.

scholarly journals Assessing the Clinical Utility of Haptoglobin to Creatinine Ratio as a Test for Detecting Nephropathy among Type 2 Diabetic Patients

2019 ◽  
Vol 2 (3) ◽  
pp. 180-184
Author(s):  
IY Mohammed ◽  
AO Busari ◽  
MB Ahmad
Keyword(s):  
Quantitative Determination ◽  
Regression Model ◽  
Clinical Utility ◽  
Diabetic Patients ◽  
Creatinine Ratio ◽  
Type 2 Diabetic Patients ◽  
Urine Albumin ◽  
Type 2 Diabetic

Diabetic nephropathy is the leading cause of diabetic complications and end-stage renal disease worldwide, especially in Nigeria. This study assessed the clinical utility of urine Albumin to Creatinine ratio (UACR) and urine Haptoglobin to Creatinine ratio (UHCR) in detecting nephropathy among type 2 diabetic patients attending Aminu Kano Teaching Hospital. Eighty (80) type 2 diabetic patients attending Aminu Kano Teaching Hospital were recruited for this study after excluding those with overt proteinuria. Blood sample was collected for quantitative determination of serum creatinine using Jaffe's method while the Urine sample was received for quantitative determination of urine albumin and urine haptoglobin levels. Linear regression model revealed a unit change in urine albumin to creatinine ratio (UACR) and urine haptoglobin to creatinine ratio (UHCR) with a significant reduction in estimated Glomerular Filtration Rate (eGFR) by 2.197ml/min and 27.969 ml/min respectively (p<0.05) when used while logistic regression model demonstrated that UHCR have 91.7% sensitivity, 95% specificity, 98% positive predictive value and 79% negative predictive compared to UACR with 83.3% sensitivity, 75% specificity, 91% positive predictive and 60% negative predictive. Based on these findings, UHCR is a good marker for detecting nephropathy in diabetic patients.

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