Details:

Alternative Title:
Clin Chem
Personal Author:
Saydah, Sharon H. ; Pavkov, Meda E. ; Zhang, Cindy ; Lacher, David A. ; Eberhardt, Mark S. ; ... More +
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. Less -
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.


Subject:
[+]
Adult
Albuminuria
Article
Cross-Sectional Studies
Female
Glomerular Filtration Rate
Humans
Male
Middle Aged
Nutrition Surveys
Prevalence

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
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:d7087c8d64018656beea423cac113d11e3feb7be8124982edcf0ab3df6bb161a
File Type:

Supporting Files

• 	NIHMS719298-supplement-supplement.doc	doc
  	nihms719298.nxml	xml
  	nihms719298f1.gif	gif
  	nihms719298f1.jpg	jpeg

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