A prospective study of protein excretion using short-interval timed urine collections in patients with lupus nephritis
A prospective study of protein excretion using short-interval timed urine collections in patients with lupus nephritis
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DOI：
10.1038/ki.2009.344
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发表时间：
2009-12-01
影响因子：
19.6
通讯作者：
Rovin, Brad H.
中科院分区：
文献类型：
--
作者：
Fine, Derek M.;Ziegenbein, Martina;Rovin, Brad H.
24小时的尿液蛋白质与促甲酸比率是评估狼疮肾炎中蛋白尿的金标准。但是，尿液收集对患者是不便的。随机尿液蛋白与造丁氨酸的比率虽然方便，但与这些患者的24小时比率一致。在这里，我们试图定义定时收集间隔，以提供准确，精确的数据和患者的便利性。 41例患者的尿液，在2个医疗中心，活检证实狼疮肾炎的尿液每隔6小时收集24小时。然后将每个简短收集的蛋白质与造胺比与组合6小时样品组合的24小时收集的比率进行了比较。分别在24小时收集之前和之后收集了第一个早晨的空隙和尿液样品。在6-12 h时峰蛋白尿存在显着的昼夜变化，在18-24h时Nadir发生了显着的变化。每个6小时的收集均与24小时蛋白质与促偶然的比率显示出极好的相关性和一致性，但是12-24小时的间隔具有最佳的一致性。与随机的尿液相反，第一个早晨空隙也具有出色的相关性和一致性，但低估了24小时的蛋白质与促偶联氨酸的比率。我们的研究表明，12小时的过夜尿液收集是最好的替代物，与24小时蛋白质与造丁氨酸的比例非常吻合，对于患者来说很方便。中心之间几乎没有差异，这是临床试验的重要特征。肾脏国际（2009）76，1284-1288; doi：10.1038/ki.2009.344; 2009年9月16日在线发布
The 24-h urine protein-to-creatinine ratio is the gold standard in evaluating proteinuria in lupus nephritis; however, the urine collection is inconvenient to the patient. Random spot urine protein-to-creatinine ratios, although convenient, have poor agreement with the 24-h ratios in these patients. Here, we sought to define a timed collection interval providing accurate and precise data and patient convenience. Urine from 41 patients, in 2 medical centers, with biopsy-proven lupus nephritis was collected at 6-h intervals for 24 h. The protein-to-creatinine ratio of each short collection was then compared with that of a 24-h collection made by combining the 6-h samples. A first morning void and spot urine samples were collected before and after the 24-h collection, respectively. There was significant diurnal variation with peak proteinuria at 6-12 h and nadir at 18-24h. Each 6-h collection showed excellent correlation and concordance with the 24-h protein-to-creatinine ratio, but the 12-24-h interval had the best agreement. In contrast to the random spot urines, the first morning void also had excellent correlation and concordance, but underestimated the 24-h protein-to-creatinine ratio. Our study shows that a 12-h overnight urine collection is the best surrogate, with excellent agreement with the 24-h protein-to-creatinine ratio, and it is convenient for patients. There was little variability between centers, an important feature for clinical trials. Kidney International (2009) 76, 1284-1288; doi:10.1038/ki.2009.344; published online 16 September 2009