An equation to estimate 24-hour total urine protein excretion rate in patients who underwent urine protein testing.
An equation to estimate 24-hour total urine protein excretion rate in patients who underwent urine protein testing.
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尿蛋白检测患者24小时总尿蛋白排泄率的估算公式。
DOI：
10.1186/s12882-022-02673-2
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发表时间：
2022-01-29
期刊：
影响因子：
2.3
通讯作者：
Le WB
中科院分区：
文献类型：
--
作者：
Yang F;Shi JS;Gong SW;Xu XD;Le WB
在接受尿蛋白检测的患者中，使用第一次晨尿样本中的尿蛋白-肌酐比率（UPCR）来估计24小时尿蛋白尿（24 hUP）。UPCR不能与24小时蛋白尿直接比较。因此，估计24小时总蛋白排泄率的方程，使用年龄，性别，和UPCR可能会改善其偏倚和准确性的患者进行尿蛋白检测。我们同时测定了肾脏疾病患者的24小时尿蛋白和当天的第一次晨尿。使用年龄、性别和UPCR构建广义线性和非线性模型来估计24小时尿蛋白，并选择最佳模型（NJ方程）来估计24小时尿蛋白（e24 hUP）。共5435对样本（包括3803例患者的训练队列和1632例患者的验证队列）同时测量UPCR和24小时尿蛋白。在训练队列中，当UPCR ≤1.2 g/g时，未经校正的UPCR明显低估了24 h尿蛋白（中位数偏倚为-0.17 g/24 h），当UPCR > 1.2 g/g时，高估了24 h尿蛋白（中位数偏倚为0.53 g/24 h）。在验证队列中，NJ方程比未调整的UPCR表现更好，均方根误差更低（0.81 vs. 1.02，P < 0.001），偏倚较小（测量和估计的尿蛋白之间的中位数差异，-0.008 vs. 0.12），提高精度（差异的四分位数范围，0.34 vs. 0.50）和更高的准确性（估计的尿蛋白百分比在测量的尿蛋白的30%内，53.4% vs. 32.2%）。Bland-Altman图表明，与较低值相比，24 hUP > 2 g时现场和每日估计值的一致性不太明显。NJ e24 hUP方程比未经校正的UPCR更准确地估计肾脏疾病患者的24 hUP，并可用于实验室应用。在线版本包含补充材料，可通过10.1186/s12882-022-02673-2获得。
The urine protein-creatinine ratio (UPCR) in a spot first-morning urine sample is used to estimate 24-h urine proteinuria (24hUP) in patients who underwent urine protein testing. UPCR cannot be directly compared with 24-h proteinuria. Thus, an equation to estimate 24-h total protein excretion rate, using age, gender, and the UPCR may improve its bias and accuracy in patients who underwent urine protein testing. We simultaneously measured 24-h urine protein and the same day’s first-morning spot urine from patients with kidney disease. Generalized linear and no-linear models, using age, gender, and UPCR, were constructed to estimate for 24-h urine protein and the best model (NJ equation) was selected to estimated 24 hUP (e24hUP). A total of 5435 paired samples (including a training cohort of 3803 patients and a validation cohort of 1632 patients) were simultaneously measured for UPCR and 24-h urine protein. In the training cohort, the unadjusted UPCR obviously underestimated 24-h urine protein when UPCR ≤1.2 g/g (median bias − 0.17 g/24 h) and overestimated 24-h urine protein when UPCR > 1.2 g/g (median bias 0.53 g/24 h). In the validation cohort, the NJ equation performed better than the unadjusted UPCR, with lower root mean square error (0.81 vs. 1.02, P < 0.001), less bias (median difference between measured and estimated urine protein, − 0.008 vs. 0.12), improved precision (interquartile range of the differences, 0.34 vs. 0.50), and greater accuracy (percentage of estimated urine protein within 30% of measured urine protein, 53.4% vs. 32.2%). Bland-Altman plot indicated that the agreement of spot and daily estimates was less pronounced with 24 hUP > 2 g than lower values. The NJ e24hUP equation is more accurate than unadjusted UPCR to estimate 24 hUP in patients with kidney disease and could be used for laboratory application. The online version contains supplementary material available at 10.1186/s12882-022-02673-2.
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作者：
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DOI：
10.1001/jama.2015.18202
发表时间：
2016-01-12
期刊：
JAMA
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