Urinary albumin excretion in Spanish children

Sánchez-Bayle, Marciano; Rodriguez-Cimadevilla, C.; Asensio, C; Ruiz-Jarabo, C; Baena, José Manuel; Arnáiz, Pilar; Villa, Sebastian; Cocho, P.

doi:10.1007/bf00866717

Cited by 26 publications

(28 citation statements)

References 13 publications

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“…Our results appear to be in closest agreement with those of 7-to 18-yr-old Italian children whose AER was not predicted by age or gender (27). In contrast to our findings, two studies report AER to be significantly related to body size (27)(28)(29) and three to age (26,28,29). However, those studies had a broader age range than the present study, and none reported results separately for the adolescent age group.…”

Section: Discussionsupporting

confidence: 86%

Albumin Excretion Rate in Normal Adolescents

Rademacher¹,

Mauer

Jacobs³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: Although albumin excretion rates have been related to cardiovascular morbidity and mortality in both diabetic and nondiabetic adults, little is known about the relation between albuminuria and either cardiovascular risk factors or the insulin resistance syndrome in adolescents. A normal range for albumin excretion in adolescents was established, correlations between albumin excretion and cardiovascular risk factors were evaluated, and albumin excretion in normal adolescents was compared with that in type 1 diabetes mellitus adolescents.Design, setting, participants, & measurements: Albumin excretion rate was measured in 368 normal and 175 diabetic adolescents. Multiple regression analysis was used to predict the relation of age, sex, Tanner stage, body mass index, and systolic blood pressure to albumin excretion in both cohorts. In addition, correlations between albumin excretion and age, blood pressure, body mass index, lipids, and measurements of insulin resistance were performed in the normal adolescents.Results: Mean albumin excretion was significantly lower in normal adolescents (4.0 g/min) than in type 1 diabetic adolescents (5.0 g/min). Albumin excretion increased with age in diabetics. Albumin excretion did not significantly correlate with any measure of cardiovascular risk or insulin resistance but did significantly correlate with fasting insulin.Conclusions: Albumin excretion rate is not related to insulin resistance or traditional cardiovascular risk factors in adolescence but is related to fasting insulin. Diabetic adolescents have increased albumin excretion compared with normal adolescents.

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Section: Discussionsupporting

confidence: 86%

Albumin Excretion Rate in Normal Adolescents

Rademacher¹,

Mauer

Jacobs³

et al. 2008

Clinical Journal of the American Society of Nephrology

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“…Houser found a higher ACR in girls only in upright or post exercise urine [23] but not supine samples. Other studies have shown conflicting results [14,26]. We saw a trend to higher ACR and BSA-adjusted UrAlb in girls, but our study power was not adequate to detect a statistical difference.…”

Section: Discussioncontrasting

confidence: 46%

“…The first morning urine albumin collection has been promoted as the most accurate sample to use in detecting children with pathologic proteinuria [9]. Albumin excretion in children has been variously reported to be influenced by age, gender, pubertal stage and body mass [3,[10][11][12][13][14]. However, the 24-hour diurnal variability in both total urine albumin and ACR in children has not been widely studied.…”

Section: Introductionmentioning

confidence: 99%

Urine albumin excretion: Characterization of normal variability in healthy children

Brandt¹,

Wong²,

Jacobs³

et al. 2013

OJPed

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Objective: Elevated urine albumin to creatinine ratio (ACR) of >30 mg/gm is a widely agreed upon indicator of pathologic albuminuria in children. However, the most reliable specimen to measure ACR in children remains undefined. We assess the range and limits of upright and supine total albumin and ACR in healthy children. Methods: Healthy children age 6 -18 years completed 24-hour and split upright and supine urine collections. Upright, supine and 24-hour protein, albumin and creatinine were measured. Primary outcomes are range and variation in urine albumin by diurnal status, age, gender, BMI percentile and Tanner stage. Results: In healthy children, with mean age 12.9 year (sd 3.2), upright ACR was 2-fold greater than supine (13.9 vs 6.8 mg/gm, p = 0.02). The range of ACR was much greater in the upright (2 -323 mg/gm) compared to the supine (1.7 -76 mg/gm) samples. The average total 24-hour urine albumin was 8.4 mg (sd 9.8) and the mean ACR was 8.9 mg/gm (sd 11.7). The 24-hour albumin increased with age and Tanner stage, but this relationship was not significant after adjusting for BSA or urine creatinine. A supine or upright ACR of >30 mg/gm was found in 5.4% of each group. However, in all subjects with an elevated ACR on an individual upright or supine sample, a second 1st am ACR sample was normal. Conclusions: In healthy children there is a marked diurnal variability in ACR with a higher value from a daytime sample compared to 1st morning specimen. Screening for pathologic albuminuria should always use a first morning urine specimen.

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“…In females, urinary albumin was higher (median 8.6 mg in females versus 6.2 mg in males, P ϭ 0.02), whereas urinary creatinine was not significantly different (median 78.0 mg in females versus 72.0 mg in males, P ϭ 0.30), indicating that the higher prevalence of abnormal ACR in females was not due to lower creatinine. Because population studies have suggested that albumin excretion is greater in younger girls, possible interactions of gender and age were examined (21,22). In the 7-to 12-year age range, females had a higher frequency of abnormal albuminuria than males (26.3% versus 13.3%, P ϭ 0.04); however, in age-stratified analysis, the effect of gender on abnormal albuminuria was NS (odds ratio 1.51, 95% CI 0.92 to 2.47), and there was no interaction between gender and age (Breslow-Day test, P ϭ 0.39).…”

Section: Albuminuriamentioning

confidence: 99%

Chronic Kidney Disease and Albuminuria in Children with Sickle Cell Disease

Yee

Jabbar

Osunkwo

et al. 2011

Clinical Journal of the American Society of Nephrology

117

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Summary Background and objectives Sickle cell nephropathy begins in childhood and may progress to renal failure. Albuminuria is a sensitive marker of glomerular damage that may indicate early chronic kidney disease (CKD). Design, setting, participants, & measurements The aims of this study were to determine the cross-sectional prevalence and clinical correlates of albuminuria and CKD among children with sickle cell disease (SCD). Over a 10-year period (1995 to 2005) 410 pediatric SCD patients ages 2 to 21 years were enrolled: 261 with hemoglobin SS (HbSS) or HbSβ0 thalassemia (HbSβ0) and 149 with HbSC or HbSβ+ thalassemia (HbSβ+). The albumin/creatinine ratio (ACR) of spot-urine specimens and serum creatinine were measured; abnormal albuminuria was defined as urinary ACR ≥ 30 mg/g. Results The prevalence of abnormal albuminuria was 20.7% (23.0% in HbSS/HbSβ0, 16.8% in HbSC/HbSβ+). Among HbSS/HbSβ0, abnormal albuminuria was associated with increasing age and lower baseline hemoglobin. GFR, estimated in 189 patients using the updated Schwartz formula, correlated negatively with age (r = −0.27, P = 0.0002). CKD defined according to the Kidney Disease: Improving Global Outcomes study was present in 26.5% (50 of 189) of patients: stage 1 in 27 (14.8%) and stage 2 in 22 (11.6%). In multivariate analysis, age and HbSC/HbSβ+ genotype were associated with CKD. Conclusions This is the first study to stage CKD in children with SCD and highlights a high prevalence of albuminuria and glomerular injury early in life. Detecting CKD in childhood could allow for earlier intervention and prevention of renal failure in adulthood.

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Urinary albumin excretion in Spanish children

Cited by 26 publications

References 13 publications

Albumin Excretion Rate in Normal Adolescents

Albumin Excretion Rate in Normal Adolescents

Urine albumin excretion: Characterization of normal variability in healthy children

Chronic Kidney Disease and Albuminuria in Children with Sickle Cell Disease

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