Document Detail

Proteinuria versus albuminuria in chronic kidney disease.
MedLine Citation:
PMID:  20586950     Owner:  NLM     Status:  MEDLINE    
Chronic kidney disease (CKD) is defined according to a decrease in the glomerular filtration rate and kidney damage such as proteinuria or albuminuria. Dip-stick proteinuria is only sensitive to albumin and correlates poorly with quantitative 24 h proteinuria, the most commonly used measure in renoprotective randomized controlled clinical trials (RCT). The amount of proteinuria correlates with the efficacy of angiotensin-converting enzyme inhibitors in non-diabetics in RCT. Random urine protein to creatinine ratio (PCR) or albumin to creatinine ratio (ACR) correlates with 24 h urinary excretion. Dip-stick proteinuria correlates poorly with ACR, while PCR correlates reasonably well with ACR. Because of a high analytical variability, efforts are in progress to standardize ACR (but not PCR) measurement. There have been no studies on the direct comparison between proteinuria and albuminuria in terms of utilities (biomarker, surrogate end-point and cost-effectiveness). In this regard, both proteinuria and albuminuria are good biomarkers for cardiovascular events, renal events or mortality. However, there are limitations in RCT regarding the validity of proteinuria or albuminuria as a surrogate end-point. In contrast, measuring proteinuria or albuminuria followed by treatment with angiotensin inhibitors is cost-effective for diabetics, hypertension and aging. CKD guidelines differ in their opinions regarding the choice between ACR and PCR. Based on the current evidence, ACR might be recommended for the diabetics and PCR for the non-diabetics.
Jinn-Yuh Guh
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Nephrology (Carlton, Vic.)     Volume:  15 Suppl 2     ISSN:  1440-1797     ISO Abbreviation:  Nephrology (Carlton)     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-30     Completed Date:  2010-10-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9615568     Medline TA:  Nephrology (Carlton)     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  53-6     Citation Subset:  IM    
Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University, Kaohsiung, Taiwan.
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MeSH Terms
Albuminuria / etiology*,  physiopathology,  urine
Biological Markers / urine*
Disease Progression
Kidney Failure, Chronic / complications*,  physiopathology,  urine
Proteinuria / etiology,  physiopathology,  urine
Reg. No./Substance:
0/Biological Markers

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