Abstract
BackgroundTo suppress increases in kidney failure and cardiovascular disease due to lifestyle-related diseases other than diabetes, early intervention is desirable. We examined whether microalbuminuria could be predicted from proteinuria.MethodsThe participants consisted of adults who exhibited a urinary protein-to-creatinine ratio (uPCR) of < 0.5 g/gCr and an eGFR of ≥ 15 ml/min/1.73 m2 in their spot urine at their first examination for lifestyle-related disease. Urine was tested three times for each case, with microalbuminuria defined as a urinary albumin-to-creatinine ratio (uACR) of 30–299 mg/gCr, at least twice on three measurements. Youden’s Index was used as an index of the cut-off value (CO) according to the ROC curve.ResultsA single uPCR was useful for differentiating normoalbuminuria and micro- and macroalbuminuria in patients with non-diabetic lifestyle-related diseases. Regarding the GFR categories, the CO of the second uPCR was 0.09 g/gCr (AUC 0.89, sensitivity 0.76, specificity 0.89) in G1-4 (n = 197) and 0.07 g/gCr (AUC 0.92, sensitivity 0.85, specificity 0.88) in G1-3a (n = 125). Using the sum of two or three uPCR measurements was more useful than a single uPCR for differentiating microalbuminuria in non-diabetic lifestyle disease [CO, 0.16 g/gCr (AUC 0.91, sensitivity 0.85, specificity 0.87) and 0.23 g/gCr (AUC 0.92, sensitivity 0.88, specificity 0.84), respectively].ConclusionMicroalbuminuria in Japanese individuals with non-diabetic lifestyle-related diseases can be predicted from the uPCR, wherein the CO of the uPCR that differentiates normoalbuminuria and micro- and macroalbuminuria was 0.07 g/gCr for G1-3a, while that in G3b-4 was 0.09 g/gCr.
Highlights
A GFR of < 60 ml/min/1.73m2 or a urinary albumin-to-creatinine ratio of ≥ 30 mg/gCr is independent risk factor for all-cause mortality, cardiovascular mortality, kidney failure, acute kidney injury, and kidney disease progression in chronic kidney disease (CKD) [1, 2]
While proteinuria was less than the measured sensitivity 44 times (7.4%) among non-diabetics and 18 times (5.7%) among diabetics, albuminuria was less than the measured sensitivity 1 time (0.7%) among non-diabetics
This study examined whether the urinary protein-to-creatinine ratio (uPCR) could differentiate normoalbuminuria and microalbuminuria in adults with lifestyle-related diseases
Summary
A GFR of < 60 ml/min/1.73m2 or a urinary albumin-to-creatinine ratio (uACR) of ≥ 30 mg/gCr is independent risk factor for all-cause mortality, cardiovascular mortality, kidney failure, acute kidney injury, and kidney disease progression in chronic kidney disease (CKD) [1, 2]. In Japan, diabetic nephropathy is the most common primary disease among the prevalent dialysis patients, and the rate of nephrosclerosis due to lifestyle-related diseases other than diabetes has beenCKD is defined as an abnormal kidney structure and function, which persist for more than 3 months in KDIGO [1]. Methods The participants consisted of adults who exhibited a urinary protein-to-creatinine ratio (uPCR) of < 0.5 g/gCr and an eGFR of ≥ 15 ml/min/1.73 m 2 in their spot urine at their first examination for lifestyle-related disease. Results A single uPCR was useful for differentiating normoalbuminuria and micro- and macroalbuminuria in patients with non-diabetic lifestyle-related diseases. Using the sum of two or three uPCR measurements was more useful than a single uPCR for differentiating microalbuminuria in non-diabetic lifestyle disease [CO, 0.16 g/gCr (AUC 0.91, sensitivity 0.85, specificity 0.87) and 0.23 g/ gCr (AUC 0.92, sensitivity 0.88, specificity 0.84), respectively]. Conclusion Microalbuminuria in Japanese individuals with non-diabetic lifestyle-related diseases can be predicted from the uPCR, wherein the CO of the uPCR that differentiates normoalbuminuria and micro- and macroalbuminuria was 0.07 g/gCr for G1-3a, while that in G3b-4 was 0.09 g/gCr
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