Random Albumin Creatinine Ratio Research Articles

The value of diffusion kurtosis imaging in early diagnosis of diabetic nephropathy model in Guangxi Bama mini pig

Objective To investigate the value of diffusion kurtosis imaging (DKI) in diagnosing early diabetic nephropathy. Methods Twelve pigs were divided into the experimental group (7 pigs) and the control group (5 pigs), used the random number table method. The experimental group was fed with high-fat high-sugar diet,and then repeatedly injected small doses (50 mg/kg) of Streptozotocin (STZ) through the ear vein. Meanwhile,the control group was fed with normal diet and injected with the same dose of citric acid-sodium citrate buffer solution.After the type 2 diabetes was established successfully, T1WI, T2WI and DKI sequence imaging were performed every month for 2 pigs from the experimental group and the control group,respectively.Mean kurtosis(MK), axial kurtosis (K∥), radial kurtosis (K⊥), fractional anisotropy (FA) and mean diffusivity(MD) were measured on the pseudo-color map of the post-processing workstation. fasting blood glucose(GLU),insulin (INS),renal function, urine routines and random albumin creatinine ratio(RACR) were measured before MRI scan. Specimens from bilateral kidneys were taken for pathological examination after MRI scan. The paired t test was used to compare the parameter values of the cortex and medulla.Independent sample t test was used tocompare the parameter values of the experimental group and the control group. Results In the experimental group,the MK, FA values of medulla were 0.66±0.07 and 0.19±0.04, the MK, FA values of cortex were 0.60±0.06 and 0.16±0.03.In the control group,the MK, FA values of medulla were 0.59±0.03 and 0.20±0.04, the MK, FA values of cortex were 0.53±0.03 and 0.17±0.04.The MK and FA values of medulla were increased compared with the cortex and the difference were statistically significant (P 0.05). Conclusion DKI sequencehas certain value in the diagnosis of early diabetic nephropathy,and to some extent reveals the pathological change in early diabetic nephropathy. Key words: Diabetic nephropathies; Magnetic resonance imaging; Disease models, animal

Diagnostic efficacy of random albumin creatinine ratio for detection of micro and macro-albuminuria in type 2 diabetes mellitus.

Objectives:To compare a less cumbersome random albumin creatinine ratio (RACR) with 24-hour urinary albumin excretion (UAE) for detection of renal damage in patients with type 2 diabetes mellitus (T2DM).Methods:This retrospective study performed between March 2013 and June 2014 at the Department of Pathology, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia included 122 patients (mean age 54±15, 104 females and 18 males) with T2DM. Urine albumin levels of <30 mg/g was considered normal, from 30-300 mg/g considered as micro-albuminuria, and over 300 mg/g considered as macro-albuminuria.Results:Concordance between the 2 assays was observed in 114 (93.4%) samples. The sensitivity of RACR assay was 100%, specificity was 91.3% with a positive predictive value (PPV) of 95%, and a negative predictive value (NPV) of 100% in micro-albuminuria range. For macro-albuminuria, RACR had a sensitivity of 100%, specificity of 94.1% with PPV of 94% and NPV of 100%. Receiver operating characteristic (ROC) curves analysis cut-off values of 40 mg/g-300 mg/g for micro- and >300 mg/g for macro-albuminuria revealed 100% sensitivity, 97.5% specificity, 95% PPV, and 100% NPV for micro-albuminuria, and 100% sensitivity, 94% specificity, 76% PPV, and 100% NPP for macro-albuminuria. The area under the curve for micro-albuminuria was 100% and 98.2% for macro-albuminuria.Conclusion:Performance of RACR was comparable to 24 hour UAE assay particularly in excluding renal damage in T2DM.

Quantification of proteinuria in mild preeclampsia with random albumin creatinine ratio

Objective: To investigate the whether spot urinealbumin/creatinine ratio (ACR) compared to the 24hurinary protein (gold standard) to detect significantproteinuria in patients with preeclampsia. Study design:80 pregnant patients diagnosed to have hypertension inlate pregnancy were instructed to collect urine during a24-hour period. Albumin creatinine ratio was evaluatedin a random urinary specimen and morning samples forquantization of proteinuria. Out of these, 78 patientsfulfilled the inclusion criteria. The predictive value of therandom urinary ACR for the diagnosis of significantproteinuria was estimated by using various cutoff valuesof urinary ACR in comparison to 24-h urine collection asthe gold standard. Results: 70 (89%) patients had preeclampsia. The meanmorning systolic blood pressure on the day of the urinecollections was 150 mmHg and mean diastolic bloodpressure 114 mmHg. The mean total protein was1961.46+1683.02 mg/24h, and the urinary ACR inrandom samples was 781.31+1041 mg/g creatinine,while in the morning sample urinary ACR was886.43+1180.9 mg/g creatinine. There was a statisticallysignificant positive correlation between in 24-hours urineproteins and ACR in both daytime and morning urinesamples. The best cutoff point for ACR in randomsample was 262.5 mg /g creatinine as with a sensitivityof 85.5% and a specificity of 81.8%, the positivepredictive value was 96.7% and negative predictive valuewas 47.4%. While the best cutoff point for ACR inmorning sample was 240 mg /g creatinine with asensitivity of 94.2% and a specificity of 63.6%, thepositive predictive value was 94.2% and negativepredictive value was 63.6%. Conclusion: Albumin/creatinine ratio is not an ideal diagnostic test to replace 24-hour urine collection for the diagnosis of preeclampsia. However, it can be used as a screening test with sensitivity 94% when the cut point of albumin/creatinine ratio of the morning urine sample is set below 240 mg/g creatinine.

Microvascular and macrovascular complications associated with diabetes in children and adolescents

Department of Pediatrics, Ulleval University˚Hospital, and Faculty of Medicine, University of Oslo, NorwayCorresponding author:Assoc. Prof. Kim DonaghueThe Children’s Hospital at Westmead, Locked Bag 4001,Westmead, NSW 2145, Australia.Tel: C61 2 9845 3172;fax: C61 2 9845 3170;e-mail: kimd@chw.edu.auAcknowledgments: Esko Wiltshire, Gisela Dahlquist, KennethLee Jones, Edna Roche, Amina Balafrej and Riccardo Bonfanti.Conflicts of interest: The authors have declared no conflictsof interest.Editors of the ISPAD Clinical Practice Consensus Guide-lines 2009 Compendium: Ragnar Hanas, Kim Donaghue,Georgeanna Klingensmith, and Peter Swift.This article is a chapter in the

Random albumin/creatinine ratio for quantification of proteinuria in manifest pre‐eclampsia

1) To assess the correlation between urine albumin/creatinine ratio (ACR) and 24-hour urine albumin excretion in women with pre-eclampsia, 2) to study the influence of potential confounders on this correlation and 3) to assess the variability of ACR between voids during a 24-hour period. Prospective study. Fetal maternity ward, university hospital. Women with pre-eclampsia scheduled for quantitative albumin measurement with a 24-hour urine collection. Random urine samples were obtained for analysis of ACRs during the time of 24-hour urine collections in 31 women. ACRs were also measured from the complete 24-hour collections. In five additional women, serial urine samples were obtained during the 24-hour collection. Correlation between ACRs and albumin amount in 24-hour urine samples. Variability of the ACRs during a 24-hour collection. The random ACR was poorly correlated to 24-hour excretion of urine albumin (R(2)= 0.42). Adjustment for maternal age and nifedipine medication significantly (P= 0.044 and P= 0.023, respectively) improved the correlation (R(2)= 0.60). The mean variability (highest/lowest) of ACR during a 24-hour period was 222%. The ACR from the 24-hour collection had an excellent correlation to 24-hour excretion of urine albumin (R(2)= 0.96). In women with pre-eclampsia, random ACR is not stable during the day and cannot predict 24-hour urine protein excretion accurately. ACR from the 24-hour collection is an accurate predictor of total albumin amount and can be used to minimise errors from incomplete collections.