Comparison of 24-h Urine Protein, Urine Albumin-to-Creatinine Ratio, and Protein-to-Creatinine Ratio in IgA Nephropathy

Frontiers in Medicine

article

Guizhen Yu¹  Jun Cheng¹  Heng Li¹  Xiayu Li¹  Jianghua Chen¹ 

[1] Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University;Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang University;National Key Clinical Department of Kidney Diseases, Zhejiang University;Institute of Nephrology, Zhejiang University;The Third Grade Laboratory Under the National State, Administration of Traditional Chinese Medicine

关键词: IgA nephropathy;    protein-to-creatinine ratio (PCR);    albumin-to-creatinine ratio (ACR);    24-h urine protein excretion (24-h UP);    kidney disease progression;   

DOI  :  10.3389/fmed.2022.809245

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Proteinuria is a strong risk factor for renal outcomes in IgA nephropathy. Random urine protein-to-creatinine ratio (PCR), random albumin-to-creatinine ratio (ACR), and 24-h urine protein excretion (24-h UP) have been widely used in clinical practice. However, the measurement which is the best predictor of long-term renal outcomes remains controversial. This study aimed to compare the three measurements in IgA nephropathy. Methods We conducted a retrospective study of 766 patients with IgA nephropathy. The associations among baseline ACR, PCR, and 24-h UP with chronic kidney disease (CKD) progression event, defined as 50% estimated glomerular filtration rate (eGFR) decline or end stage kidney disease (ESKD), were tested and compared. Results In this study, ACR, PCR, and 24-h UP showed high correlation ( r = 0.671–0.847, P < 0.001). After a median follow-up of 29.88 (14.65–51.65) months, 51 (6.66%) patients reached the CKD progression event. In univariate analysis, ACR performed better in predicting the prognosis of IgA nephropathy, with a higher area under the receiver operating curve (ROC) curve than PCR and 24-h UP. After adjustment for traditional risk factors, ACR was most associated with composite CKD progression event [per log-transformed ACR, hazard ratio (HR): 2.82; 95% (95% CI): 1.31–6.08; P = 0.008]. Conclusions In IgA nephropathy, ACR, PCR, and 24-h UP had a high correlation. ACR performed better in predicting the prognosis of IgA nephropathy.

【 授权许可】

CC BY