| Proteinuria versus albuminuria in chronic kidney disease. | |
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MedLine Citation:
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PMID: 20586950 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Jinn-Yuh Guh |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Nephrology (Carlton, Vic.) Volume: 15 Suppl 2 ISSN: 1440-1797 ISO Abbreviation: Nephrology (Carlton) Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-30 Completed Date: 2010-10-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9615568 Medline TA: Nephrology (Carlton) Country: Australia |
Other Details:
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Languages: eng Pagination: 53-6 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Division of Nephrology, Kaohsiung Medical University, Kaohsiung, Taiwan. guhjy@kmu.edu.tw |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Albuminuria
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etiology*,
physiopathology,
urine Biological Markers / urine* Disease Progression Humans Kidney Failure, Chronic / complications*, physiopathology, urine Proteinuria / etiology, physiopathology, urine |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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