Albumin: Creatinine ratio - A flawed measure? The merits of estimated albuminuria reporting

Nephron - Clinical Practice

Volumn 118, Issue 4, 2011, Pages

  Ellam, Timothy J ^a,b  

^a NORTHERN GENERAL HOSPITAL   (United Kingdom)

^b NIHR Cardiovascular Biomedical Research Unit   (United Kingdom)

Author keywords

Albuminuria; Glomerular filtration rate; Proteinuria

Indexed keywords

ALBUMIN; CREATININE;

ADOLESCENT; ADULT; ALBUMINURIA; CARDIOVASCULAR DISEASE; CIRCADIAN RHYTHM; CLINICAL PRACTICE; CREATININE URINE LEVEL; DIABETES MELLITUS; DIABETIC PATIENT; DISEASE COURSE; ETHNICITY; FEMALE; GLOMERULUS FILTRATION RATE; HUMAN; KIDNEY FUNCTION; MAJOR CLINICAL STUDY; MALE; MEASUREMENT; MORTALITY; MUSCLE MASS; PRACTICE GUIDELINE; PREDICTION; PRIORITY JOURNAL; PROGNOSIS; PROTEIN URINE LEVEL; PROTEINURIA; QUANTITATIVE ANALYSIS; REVIEW; SAMPLING; SEX DIFFERENCE; URINARY EXCRETION;

AGE FACTORS; ALBUMINURIA; ANIMALS; BIOLOGICAL MARKERS; BODY SURFACE AREA; CREATININE; GLOMERULAR FILTRATION RATE; HUMANS; KIDNEY FUNCTION TESTS; SEX FACTORS;

EID: 79551508982     PISSN: None     EISSN: 16602110     Source Type: Journal    
DOI: 10.1159/000323670     Document Type: Review

References (37)

1. Hallan SI, Orth SR: The K/DOQI 2002 classification of chronic kidney disease: For whom the bell tolls. Nephrol Dial Transplant 2010; 25: 2832-2836.
2. Early identification and management of chronic kidney disease in adults in primary and secondary care (http://wwwnice.org.uk/ cg73).
3. K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am J Kidney Dis 2002; 39:S1-S266.
4. Cockcroft DW, Gault MH: Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16: 31-41.
5. Ginsberg JM, Chang BS, Matarese RA, Garella S: Use of single voided urine samples to estimate quantitative proteinuria. N Engl J Med 1983; 309: 1543-1546. (Pubitemid 14212836)
6. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D: A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999; 130: 461-470. (Pubitemid 29135798)
7. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J: A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150: 604-612.
8. Sardinha LB, Carnero EA, Martins S, Branco T, Teixeira PJ: Body surface area estimation and its impact on predicting appendicular skeletal muscle mass with a mechanistic model based on the reference man. Acta Diabetol 2003; 40(suppl 1):S29-S31. (Pubitemid 37322713)
9. Rose BD PT: Measurement of urinary protein excretion (www.uptodate.com). 2010.
10. Delanaye P, Mariat C, Cavalier E, Krzesinski JM: Errors induced by indexing glomerular filtration rate for body surface area: Reductio ad absurdum. Nephrol Dial Transplant 2009; 24: 3593-3596.
11. Schwab SJ, Christensen RL, Dougherty K, Klahr S: Quantitation of proteinuria by the use of protein-to-creatinine ratios in single urine samples. Arch Intern Med 1987; 147: 943-944. (Pubitemid 17082488)
12. Methven S, MacGregor MS, Traynor JP, O'Reilly DS, Deighan CJ: Assessing proteinuria in chronic kidney disease: Protein-creatinine ratio versus albumin-creatinine ratio. Nephrol Dial Transplant 2010; 25: 2991-2996.
13. Younes N, Cleary PA, Steffes MW, de Boer IH, Molitch ME, Rutledge BN, Lachin JM, Dahms W: Comparison of urinary albumin:creatinine ratio and albumin excretion rate in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study. Clin J Am Soc Nephrol 2010; 5: 1235-1242.
14. Jafar TH, Chaturvedi N, Hatcher J, Levey AS: Use of albumin creatinine ratio and urine albumin concentration as a screening test for albuminuria in an Indo-Asian population. Nephrol Dial Transplant 2007; 22: 2194-2200. (Pubitemid 47244696)
15. Cirillo M, Laurenzi M, Mancini M, Zanchetti A, De Santo NG: Low muscular mass and overestimation of microalbuminuria by urinary albumin/creatinine ratio. Hypertension 2006; 47: 56-61. (Pubitemid 43177816)
16. Jafar TH, Schmid CH, Levey AS: Serum creatinine as marker of kidney function in South Asians: A study of reduced GFR in adults in Pakistan. J Am Soc Nephrol 2005; 16: 1413-1419. (Pubitemid 41716525)
17. Jacobs DR Jr., Murtaugh MA, Steffes M, Yu X, Roseman J, Goetz FC: Gender-and race-specific determination of albumin excretion rate using albumin-to-creatinine ratio in single, untimed urine specimens: The coronary artery risk development in young adults study. Am J Epidemiol 2002; 155: 1114-1119. (Pubitemid 34625500)
18. James GD, Sealey JE, Alderman M, Ljungman S, Mueller FB, Pecker MS, Laragh JH: A longitudinal study of urinary creatinine and creatinine clearance in normal subjects. Race, sex, and age differences. Am J Hypertens 1988; 1: 124-131.
19. Warram JH, Gearin G, Laffel L, Krolewski AS: Effect of duration of type 1 diabetes on the prevalence of stages of diabetic nephropathy defined by urinary albumin/creatinine ratio. J Am Soc Nephrol 1996; 7: 930-937. (Pubitemid 27465988)
20. Cirillo M, Senigalliesi L, Laurenzi M, Alfieri R, Stamler J, Stamler R, Panarelli W, De Santo NG: Microalbuminuria in nondiabetic adults: Relation of blood pressure, body mass index, plasma cholesterol levels, and smoking: The Gubbio Population Study. Arch Intern Med 1998; 158: 1933-1939. (Pubitemid 28440868)
21. Standards of medical care in diabetes, 2010. Diabetes Care 2010; 33(suppl 1):S11-S61.
22. Garg AX, Kiberd BA, Clark WF, Haynes RB, Clase CM: Albuminuria and renal insufficiency prevalence guides population screening: Results from the NHANES III. Kidney Int 2002; 61: 2165-2175. (Pubitemid 34539334)
23. Mattix HJ, Hsu CY, Shaykevich S, Curhan G: Use of the albumin/creatinine ratio to detect microalbuminuria: Implications of sex and race. J Am Soc Nephrol 2002; 13: 1034-1039. (Pubitemid 34274100)
24. Jacobsen FK, Christensen CK, Mogensen CE, Andreasen F, Heilskov NS: Postprandial serum creatinine increase in normal subjects after eating cooked meat. Proc Eur Dial Transplant Assoc 1979; 16: 506-512.
25. Witte EC, Lambers Heerspink HJ, de Zeeuw D, Bakker SJ, de Jong PE, Gansevoort R: First morning voids are more reliable than spot urine samples to assess microalbuminuria. J Am Soc Nephrol 2009; 20: 436-443.
26. Matsushita K, van der Velde M, Astor BC, Woodward M, Levey AS, de Jong PE, Coresh J, Gansevoort RT: Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: A collaborative meta-analysis. Lancet 2010; 375: 2073-2081.
27. Hemmelgarn BR, Manns BJ, Lloyd A, James MT, Klarenbach S, Quinn RR, Wiebe N, Tonelli M: Relation between kidney function, proteinuria, and adverse outcomes. JAMA 2010; 303: 423-429.
28. Ruggenenti P, Gaspari F, Perna A, Remuzzi G: Cross-sectional longitudinal study of spot morning urine protein:creatinine ratio, 24-hour urine protein excretion rate, glomerular filtration rate, and end-stage renal failure in chronic renal disease in patients without diabetes. BMJ 1998; 316: 504-509. (Pubitemid 28120955)
29. Lambers Heerspink HJ, Gansevoort RT, Brenner BM, Cooper ME, Parving HH, Shahinfar S, de Zeeuw D: Comparison of different measures of urinary protein excretion for prediction of renal events. J Am Soc Nephrol 2010; 21: 1355-1360.
30. Hallan SI, Ritz E, Lydersen S, Romundstad S, Kvenild K, Orth SR: Combining GFR and albuminuria to classify CKD improves prediction of ESRD. J Am Soc Nephrol 2009; 20: 1069-1077.
31. Gerstein HC, Mann JF, Yi Q, Zinman B, Dinneen SF, Hoogwerf B, Halle JP, Young J, Rashkow A, Joyce C, Nawaz S, Yusuf S: Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA 2001; 286: 421-426. (Pubitemid 32681484)
32. Hillege HL, Fidler V, Diercks GF, van Gilst WH, de Zeeuw D, van Veldhuisen DJ, Gans RO, Janssen WM, Grobbee DE, de Jong PE: Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population. Circulation 2002; 106: 1777-1782.
33. Gansevoort RT, Lambers H, Witte EC: Methodology of screening for albuminuria. Nephrol Dial Transplant 2007; 22: 2109-2111. (Pubitemid 47244682)
34. Ix JH, de Boer IH, Wassel CL, Criqui MH, Shlipak MG, Whooley MA: Urinary creatinine excretion rate and mortality in persons with coronary artery disease: The Heart and Soul Study. Circulation 2010; 121: 1295-1303.
35. Oterdoom LH, Gansevoort RT, Schouten JP, de Jong PE, Gans RO, Bakker SJ: Urinary creatinine excretion, an indirect measure of muscle mass, is an independent predictor of cardiovascular disease and mortality in the general population. Atherosclerosis 2009; 207: 534-540.
36. Oterdoom LH, van Ree RM, de Vries AP, Gansevoort RT, Schouten JP, van Son WJ, Homan van der Heide JJ, Navis G, de Jong PE, Gans RO, Bakker SJ: Urinary creatinine excretion reflecting muscle mass is a predictor of mortality and graft loss in renal transplant recipients. Transplantation 2008; 86: 391-398.
37. Ellam T, El-Nahas AM: Proteinuria thresholds are irrational: A call for proteinuria indexing. Nephron Clin Pract 2011 (in press).