The relatively poor correlation between random and 24-hour urine protein excretion in patients with biopsy-proven glomerular diseases.
The relatively poor correlation between random and 24-hour urine protein excretion in patients with biopsy-proven glomerular diseases.
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DOI：
10.1016/j.kint.2016.06.020
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发表时间：
2016-11
影响因子：
19.6
通讯作者：
Lieske, John C.
中科院分区：
文献类型：
--
作者：
Hogan, Marie C.;Reich, Heather N.;Nelson, Peter J.;Adler, Sharon G.;Cattran, Daniel C.;Appel, Gerald B.;Gipson, Debbie S.;Kretzler, Matthias;Troost, Jonathan P.;Lieske, John C.
随机尿蛋白肌酸酐比率用于估计24小时尿蛋白排泄，其被认为是诊断金标准。然而，很少有研究可用于肾小球蛋白尿患者的敏感性和特异性的估计。为了阐明这一点，我们在随机和24小时尿液活检中集中测量了尿蛋白和肌酐，并在参与肾病综合征研究网络（NEPTUNE）肾小球疾病队列的个体中每6个月纵向测量一次。在初始发育队列中，302例患者在同一天随机采集24小时样本，在所有访视中共进行了827次配对测量。成人患者的蛋白排泄量（g/天）高于儿童患者。两组中随机尿蛋白肌酐比值与24小时尿蛋白排泄量之间的相关性为中度（r分别为0.60和0.67）。然而，数值的Log 10转换加强了两组的相关性（r分别为0.85和0.82）。肥胖患者之间的相关性较强。预测方程的开发和验证，在232个独特的情况下，海王星（R2为0.65）。因此，在肾小球疾病和蛋白尿患者中，尿蛋白肌酐比值与24小时尿蛋白排泄量仅中度相关。然而，开发了一个估计方程，从随机尿蛋白肌酐比值中推导出24小时尿蛋白排泄量，并提高了精确度。Log 10转换的随机蛋白肌酐比值的长期预后价值需要进一步研究。
Random urine protein creatinine ratios are used to estimate 24-hour urine protein excretion which is considered a diagnostic gold standard. However, few studies are available of the sensitivity and specificity of this estimation in patients with glomerular proteinuria. To clarify this, we measured the urine protein and creatinine centrally in random and 24-hour urine collections at biopsy and longitudinally every 6 months in individuals participating in the Nephrotic Syndrome Study Network (NEPTUNE) cohort with glomerular disease. In the initial developmental cohort, 302 patients had same day random and 24-hour samples with a total of 827 paired measurements across all visits. The protein excretion (g/day) was higher in adult than pediatric patients. The correlation between the random urine protein creatinine ratio and 24-hour urine protein excretion was moderate in both groups (r of 0.60 and 0.67, respectively). However, the Log10 transformation of values strengthened correlations in both groups (r of 0.85 and 0.82, respectively). Associations were moderately stronger among obese patients. Prediction equations were developed and validated in 232 unique cases from NEPTUNE (R2 of 0.65). Thus, in patients with glomerular disease and proteinuria, the urine protein creatinine ratio correlates only moderately with 24-hour urine protein excretion. However an estimating equation was developed to derive 24-hour urine protein excretion from random urine protein creatinine ratio values with improved precision. The long term prognostic value of Log10 transformed random protein creatinine ratios values requires future study.
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影响因子：
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