Back to Search
Start Over
Conversion of Urine Protein-Creatinine Ratio or Urine Dipstick Protein to Urine Albumin-Creatinine Ratio for Use in Chronic Kidney Disease Screening and Prognosis: An Individual Participant-Based Meta-analysis
- Source :
- Annals of Internal Medicine, 173(6), 426-435. AMER COLL PHYSICIANS, Annals of internal medicine, Annals of internal medicine, 2020, 173 (6), pp.426-435. ⟨10.7326/M20-0529⟩, Annals of Internal Medicine C.2, 173, 6, pp. 426-435, Annals of Internal Medicine C.2, 173, 426-435
- Publication Year :
- 2020
-
Abstract
- BACKGROUND: Although measuring albuminuria is the preferred method for defining and staging chronic kidney disease (CKD), total urine protein or dipstick protein is often measured instead.OBJECTIVE: To develop equations for converting urine protein-creatinine ratio (PCR) and dipstick protein to urine albumin-creatinine ratio (ACR) and to test their diagnostic accuracy in CKD screening and staging.DESIGN: Individual participant-based meta-analysis.SETTING: 12 research and 21 clinical cohorts.PARTICIPANTS: 919 383 adults with same-day measures of ACR and PCR or dipstick protein.MEASUREMENTS: Equations to convert urine PCR and dipstick protein to ACR were developed and tested for purposes of CKD screening (ACR ≥30 mg/g) and staging (stage A2: ACR of 30 to 299 mg/g; stage A3: ACR ≥300 mg/g).RESULTS: Median ACR was 14 mg/g (25th to 75th percentile of cohorts, 5 to 25 mg/g). The association between PCR and ACR was inconsistent for PCR values less than 50 mg/g. For higher PCR values, the PCR conversion equations demonstrated moderate sensitivity (91%, 75%, and 87%) and specificity (87%, 89%, and 98%) for screening (ACR >30 mg/g) and classification into stages A2 and A3, respectively. Urine dipstick categories of trace or greater, trace to +, and ++ for screening for ACR values greater than 30 mg/g and classification into stages A2 and A3, respectively, had moderate sensitivity (62%, 36%, and 78%) and high specificity (88%, 88%, and 98%). For individual risk prediction, the estimated 2-year 4-variable kidney failure risk equation using predicted ACR from PCR had discrimination similar to that of using observed ACR.LIMITATION: Diverse methods of ACR and PCR quantification were used; measurements were not always performed in the same urine sample.CONCLUSION: Urine ACR is the preferred measure of albuminuria; however, if ACR is not available, predicted ACR from PCR or urine dipstick protein may help in CKD screening, staging, and prognosis.PRIMARY FUNDING SOURCE: National Institute of Diabetes and Digestive and Kidney Diseases and National Kidney Foundation.
- Subjects :
- Male
musculoskeletal diseases
medicine.medical_specialty
[SDV]Life Sciences [q-bio]
Urology
Renal function
Urine
Urinalysis
01 natural sciences
Sensitivity and Specificity
03 medical and health sciences
0302 clinical medicine
immune system diseases
Diabetes mellitus
Internal Medicine
Medicine
Albuminuria
Humans
Mass Screening
030212 general & internal medicine
0101 mathematics
Stage (cooking)
Renal Insufficiency, Chronic
skin and connective tissue diseases
Reagent Strips
Kidney
business.industry
010102 general mathematics
General Medicine
Dipstick
Middle Aged
medicine.disease
Prognosis
3. Good health
Proteinuria
medicine.anatomical_structure
Creatinine
Female
medicine.symptom
Renal disorders Radboud Institute for Health Sciences [Radboudumc 11]
business
Kidney disease
Subjects
Details
- Language :
- English
- ISSN :
- 00034819 and 15393704
- Database :
- OpenAIRE
- Journal :
- Annals of Internal Medicine, 173(6), 426-435. AMER COLL PHYSICIANS, Annals of internal medicine, Annals of internal medicine, 2020, 173 (6), pp.426-435. ⟨10.7326/M20-0529⟩, Annals of Internal Medicine C.2, 173, 6, pp. 426-435, Annals of Internal Medicine C.2, 173, 426-435
- Accession number :
- edsair.doi.dedup.....974abc466522c70f2958a6b77e827900