Accuracy of the urinary albumin to creatinine ratio as a predictor of albuminuria in adults with sickle cell disease

Lima, Carmen S. P.; Bottini, P.V.; Garlipp, Célia Regina; Santos, Allan O.; Costa, Fernando Ferreira; Saad, Sara T Olalla

doi:10.1136/jcp.55.12.973

Cited by 15 publications

(16 citation statements)

References 8 publications

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“…13 24 hours urine collection, which is the gold standard used to estimate proteinuria has its own drawbacks like it is cumbersome and there is problem in accuracy of collection which depends on patient. 9,14 In order to overcome the 24 hrs. collection procedures, the scientists ultimately discovered methods like single voided spot urine Albumin: Creatinine ratio in the presence of stable Glomerular Filtration Rate.…”

Section: Resultsmentioning

confidence: 99%

Role of Urinary Albumin to Creatinine Ratio and Spot Albuminuria in Predicting Significant Albuminuria in Patients of Diabetic Nephropathy

Gitanjali¹,

Goyal²,

Panag³

2014

jemds

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INTRODUCTION:Diabetic nephropathy is the most common cause of End Stage Renal Disease (ESRD).The earliest clinical evidence of nephropathy is microalbuminuria. The commonly used investigations to diagnose microalbuminuria include 24 hours urinary Albumin Excretion Rate (AER), Albumin to Creatinine ratio (ACR) and spot microalbuminuria. These latter two methods have been found to be convenient, cost effective and efficient in screening patients of microalbuminuria when compared with 24 hour collections.AIM OF STUDY: The present study was conducted to know whether ACR or spot microalbuminuria alone can predict and quantify microalbuminuria in patients with Diabetic Nephropathy.METHODOLOGY:100 known patients of type II DM were enrolled for the study. 24 hour urinary sample was taken to quantify albuminuria and spot urine sample was taken for ACR and microalbuminuria. The results obtained by ACR and spot microalbuminuria were compared with the gold standard 24 hours urinary protein measurement.RESULTS:Sensitivity and specificity for predicting true microalbuminuria were found to be 91% and 75% respectively for ACR. Its positive predictive value was 57% and negative predictive value was 90%. Sensitivity and specificity were found to be 92% and 82% for spot microalbuminuria with positive predictive value of 40% and negative predictive value of 95%.CONCLUSION:The low specificity and low positive predictive value of ACR and spot microalbumin does not support their use for quantifying urinary albumin excretion and it was concluded that these methods alone cannot be relied upon for quantification of albuminuria. However the high sensitivity and negative predictive value of the tests suggests that these are good routine outdoor screening tests for finding out those patients who should undergo quantification by 24 hours urine albumin excretion.

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Section: Resultsmentioning

confidence: 99%

Role of Urinary Albumin to Creatinine Ratio and Spot Albuminuria in Predicting Significant Albuminuria in Patients of Diabetic Nephropathy

Gitanjali¹,

Goyal²,

Panag³

2014

jemds

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“…To be included, a patient's chart had to contain all of the following data: hemoglobin (Hb) electrophoresis, gender, age, BMI (BMI = weight (kg)/height 2 (m 2 )), serum creatinine, estimated creatinine clearance, glomerular filtration rate (GFR), microalbuminuria, hemoglobin (Hb) levels, reticulocyte counts, serum lactate dehydrogenase (LDH) levels, and a BMD assessment. Microalbuminuria was measured using the nephelometric method with nocturnal 12-hour urine 15. Creatinine clearance was estimated by the Cockcroft-Gault formula 16.…”

Section: Methodsmentioning

confidence: 99%

Low bone mass density is associated with hemolysis in brazilian patients with sickle cell disease

Baldanzi

Traina

Neto

et al. 2011

Clinics

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OBJECTIVES:To determine whether kidney disease and hemolysis are associated with bone mass density in a population of adult Brazilian patients with sickle cell disease. INTRODUCTION:Bone involvement is a frequent clinical manifestation of sickle cell disease, and it has multiple causes; however, there are few consistent clinical associations between bone involvement and sickle cell disease.METHODS:Patients over 20 years of age with sickle cell disease who were regularly followed at the Hematology and Hemotherapy Center of Campinas, Brazil, were sorted into three groups, including those with normal bone mass density, those with osteopenia, and those with osteoporosis, according to the World Health Organization criteria. The clinical data of the patients were compared using statistical analyses.RESULTS:In total, 65 patients were included in this study: 12 (18.5%) with normal bone mass density, 37 (57%) with osteopenia and 16 (24.5%) with osteoporosis. Overall, 53 patients (81.5%) had bone mass densities below normal standards. Osteopenia and osteoporosis patients had increased lactate dehydrogenase levels and reticulocyte counts compared to patients with normal bone mass density (p<0.05). Osteoporosis patients also had decreased hemoglobin levels (p<0.05). Hemolysis was significantly increased in patients with osteoporosis compared with patients with osteopenia, as indicated by increased lactate dehydrogenase levels and reticulocyte counts as well as decreased hemoglobin levels. Osteoporosis patients were older, with lower glomerular filtration rates than patients with osteopenia. There was no significant difference between the groups with regard to gender, body mass index, serum creatinine levels, estimated creatinine clearance, or microalbuminuria.CONCLUSION:A high prevalence of reduced bone mass density that was associated with hemolysis was found in this population, as indicated by the high lactate dehydrogenase levels, increased reticulocyte counts and low hemoglobin levels.

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“…Microalbuminuria was measured using the nephelometric method with nocturnal 12-hour urine. 15 Creatinine clearance was estimated by the Cockcroft-Gault formula. 16 Glomerular filtration rate was estimated by measuring 51Cr-EDTA clearance.…”

Section: Methodsmentioning

confidence: 99%

Low Bone Mass Density is Associated with Hemolysis in Brazilian Patients with Sickle Cell Disease

Ribeiero

Santos²,

Baldanzi³

et al. 2015

Journal of Clinical Densitometry

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Accuracy of the urinary albumin to creatinine ratio as a predictor of albuminuria in adults with sickle cell disease

Cited by 15 publications

References 8 publications

Role of Urinary Albumin to Creatinine Ratio and Spot Albuminuria in Predicting Significant Albuminuria in Patients of Diabetic Nephropathy

Role of Urinary Albumin to Creatinine Ratio and Spot Albuminuria in Predicting Significant Albuminuria in Patients of Diabetic Nephropathy

Low bone mass density is associated with hemolysis in brazilian patients with sickle cell disease

Low Bone Mass Density is Associated with Hemolysis in Brazilian Patients with Sickle Cell Disease

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