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The urine albumin-to-creatinine ratio is a reliable indicator for evaluating complications of chronic kidney disease and progression in IgA nephropathy in China

Huan, Lu ; Yuezhong, Luo ; Chao, Wang ; HaiTao, Tu

Clinics (São Paulo, Brazil), 2016-05, Vol.71 (5), p.243-250 [Periódico revisado por pares]

Brazil: Elsevier España, S.L.U

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  • Título:
    The urine albumin-to-creatinine ratio is a reliable indicator for evaluating complications of chronic kidney disease and progression in IgA nephropathy in China
  • Autor: Huan, Lu ; Yuezhong, Luo ; Chao, Wang ; HaiTao, Tu
  • Assuntos: Adult ; Albuminuria ; Albuminuria - urine ; Biomarkers - urine ; China ; Chronic Kidney Disease ; Clinical Science ; Creatinine - urine ; Cross-Sectional Studies ; Disease Progression ; Female ; Glomerulonephritis ; Glomerulonephritis, IGA - urine ; Humans ; IgA Nephropathy ; Male ; MEDICINE, GENERAL & INTERNAL ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Proteinuria ; Proteinuria - urine ; Renal Insufficiency, Chronic - classification ; Renal Insufficiency, Chronic - urine ; Time Factors ; Young Adult
  • É parte de: Clinics (São Paulo, Brazil), 2016-05, Vol.71 (5), p.243-250
  • Notas: ObjectType-Article-1
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  • Descrição: This study investigated the correlation between the albumin-to-creatinine ratio in the urine and 24-hour urine proteinuria and whether the ratio can predict chronic kidney disease progression even more reliably than 24-hour proteinuria can, particularly in primary IgA nephropathy. A total of 182 patients with primary IgA nephropathy were evaluated. Their mean urine albumin-to-creatinine ratio and 24-hour proteinuria were determined during hospitalization. Blood samples were also analyzed. Follow-up data were recorded for 44 patients. A cross-sectional study was then conducted to test the correlation between these parameters and their associations with chronic kidney disease complications. Subsequently, a canonical correlation analysis was employed to assess the correlation between baseline proteinuria and parameters of the Oxford classification. Finally, a prospective observational study was performed to evaluate the association between proteinuria and clinical outcomes. Our study is registered in the Chinese Clinical Trial Registry, and the registration number is ChiCTR-OCH-14005137. A strong correlation (r=0.81, p<0.001) was found between the ratio and 24-hour proteinuria except in chronic kidney disease stage 5. First-morning urine albumin-to-creatinine ratios of ≥125.15, 154.44 and 760.31 mg/g reliably predicted equivalent 24-hour proteinuria ‘thresholds’ of ≥0.15, 0.3 and 1.0 g/24 h, respectively. In continuous analyses, the albumin-to-creatinine ratio was significantly associated with anemia, acidosis, hypoalbuminemia, hyperphosphatemia, hyperkalemia, hypercholesterolemia and higher serum cystatin C. However, higher 24-hour proteinuria was only associated with hypoalbuminemia and hypercholesterolemia. Higher tubular atrophy and interstitial fibrosis scores were also associated with a greater albumin-to-creatinine ratio, as observed in the canonical correlation analysis. Finally, the albumin-to-creatinine ratio and 24-hour proteinuria were associated with renal outcomes in univariate analyses. This study supports the recommendation of using the albumin-to-creatinine ratio, rather than 24-hour proteinuria, to monitor proteinuria and prognosis in primary IgA nephropathy.
  • Editor: Brazil: Elsevier España, S.L.U
  • Idioma: Inglês;Português
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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