Abstract
BackgroundThe Kidney Disease: Improving Global Outcomes chronic kidney disease (CKD) guidelines recommend that CKD be classified based on the etiology, glomerular filtration rate (GFR) and degree of albuminuria. The present study aimed to establish a method that predicts the presence of microalbuminuria by measuring the total urine protein-to-creatinine ratio (TPCR) in patients with cardiovascular disease (CVD) risk factors.Methods and ResultsWe obtained urine samples from 1,033 patients who visited the cardiovascular clinic at St. Luke's International Hospital from February 2012 to August 2012. We measured the TPCR and the urine albumin-to-creatinine ratio (ACR) from random spot urine samples. We performed correlation, receiver operating characteristic (ROC) curve, sensitivity, and subgroup analyses. There was a strong positive correlation between the TPCR and ACR (R2 = 0.861, p<0.001). A ROC curve analysis for the TPCR revealed a sensitivity of 94.4%, a specificity of 86.1%, and an area under the curve of 0.903 for detecting microalbuminuria for a TPCR cut-off value of 84 mg/g of creatinine. The subgroup analysis indicated that the cut-off value could be used for patients with CVD risk factors.ConclusionsThese results suggest that the TPCR with an appropriate cut-off value could be used to screen for the presence of microalbuminuria in patients with CVD risk factors. This simple, inexpensive measurement has broader applications, leading to earlier intervention and public benefit.
Highlights
Microalbuminuria is an early sign of progressive cardiovascular and renal disease in individuals with certain conditions, such as hypertension, diabetes mellitus, and cardiovascular disease (CVD) [1,2]
These results suggest that the TPCR with an appropriate cut-off value could be used to screen for the presence of microalbuminuria in patients with CVD risk factors
Microalbuminuria is preferred as a marker over the total urine protein-to-creatinine ratio (TPCR), the cost of measuring albumin may limit its use in some countries [8,9,10,11]
Summary
Microalbuminuria is an early sign of progressive cardiovascular and renal disease in individuals with certain conditions, such as hypertension, diabetes mellitus, and cardiovascular disease (CVD) [1,2]. The Kidney Disease: Improving Global Outcomes (KDIGO) CKD guidelines recommend that CKD should be classified based on the cause, glomerular filtration rate and degree of albuminuria [7]. Microalbuminuria is preferred as a marker over the total urine protein-to-creatinine ratio (TPCR), the cost of measuring albumin may limit its use in some countries [8,9,10,11]. The Kidney Disease: Improving Global Outcomes chronic kidney disease (CKD) guidelines recommend that CKD be classified based on the etiology, glomerular filtration rate (GFR) and degree of albuminuria. The present study aimed to establish a method that predicts the presence of microalbuminuria by measuring the total urine protein-to-creatinine ratio (TPCR) in patients with cardiovascular disease (CVD) risk factors
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