Albuminuria Prevalence in First Morning Void Compared with Previous Random Urine from Adults in the National Health and Nutrition Examination Survey, 2009–2010

Details

• Alternative Title:
  Clin Chem
• Personal Author:
  Saydah, Sharon H. ; Pavkov, Meda E. ; Zhang, Cindy ; Lacher, David A. ; Eberhardt, Mark S. ; Burrows, Nilka Rios ; Narva, Andrew S. ; Eggers, Paul W. ; Williams, Desmond E.
• Description:
  BACKGROUND
  
  Albuminuria, defined as urine albumin/creatinine ratio (ACR) ≥30 mg/g, is a diagnostic component of chronic kidney disease (CKD). National estimates of ACR and CKD prevalence have been based on single random urine samples. Although 2 urine samples or a first morning void are known to produce different estimates of ACR, the impact of differing urine sampling schemes on nationally estimated rates of CKD is unknown.
  
  METHODS
  
  In 2009–2010, the National Health and Nutrition Examination Survey (NHANES) participants provided 2 untimed urine samples for sequential ACR measurement: an initial random urine collected in the NHANES mobile examination center and a subsequent first morning void collected at home. Rates of albuminuria were calculated in the overall population and broken down by demographics, diagnosed diabetes and hypertension status, and estimated glomerular filtration rate (eGFR).
  
  RESULTS
  
  Overall, 43.5% of adults with increased ACR (≥30 mg/g) in a random urine also had increased ACR in a first morning urine. This percentage was higher among individuals ≥50 years old (48.9%), males (53.3%), participants with diagnosed diabetes (56.3%) and hypertension (51.5%), and eGFR <60 mL/min/1.72m2 (56.9%). The use of confirmed increased ACR (defined as the presence of ACR ≥30 mg/g in both samples taken within 10 days) to define CKD resulted in a lower overall prevalence (11.6%) than first morning urine (12.7%) or random spot urine only (15.2%).
  
  CONCLUSIONS
  
  ACR measured on random urine samples appears to overestimate the prevalence of albuminuria compared to first morning urine collections.
  
  
• Subjects:
  Adult Albuminuria Article Cross-Sectional Studies Female Glomerular Filtration Rate Humans Male Middle Aged Nutrition Surveys Prevalence

  More +
• Source:
  Clin Chem. 59(4):675-683
• Pubmed ID:
  23315482
• Pubmed Central ID:
  PMC4562457
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  59
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d7087c8d64018656beea423cac113d11e3feb7be8124982edcf0ab3df6bb161a
• Download URL:
  https://stacks.cdc.gov/view/cdc/34142/cdc_34142_DS1.pdf
• File Type:
  [PDF - 547.25 KB ]