scholarly journals The role of urine albumin creatinine ratio and serum β2 microglobulin as biomarkers of chronic kidney disease

2019 ◽  
Vol 38 (3) ◽  
pp. 172
Author(s):  
Augustine Onovuakpo Eguvbe ◽  
Marcellinus Uchechukwu Nwagu ◽  
Eshiotseme Sylvester Idogun ◽  
Adeyinka Abdulrasaq Akande
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Receiver Operating Curve ◽  
Strong Positive Correlation ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Β2 Microglobulin ◽  
Urine Albumin ◽  
Urine Albumin Creatinine Ratio

<p><strong>BACKGROUND</strong></p><p>Chronic kidney disease (CKD) is an increasing burden on individuals and on the healthcare system. The need to identify more sensitive and specific markers of CKD cannot be overemphasized to facilitate detection and appropriate intervention. β2 microglobulin is one of such markers of CKD. The aim of this study was to investigate the sensitivities and specificities of serum β2 microglobulin and major biochemical markers of CKD, namely creatinine and urine albumin.</p><p><strong> </strong></p><p><strong>METHODS</strong></p><p>This was a hospital-based cross-sectional study involving 124 subjects with CKD and 124 healthy controls. Participants were categorized in two groups : group 1 the CKD based on persistent reduction in GFR &lt;60 mL/min/1.73 m2 and group 2 healthy subjects as controls. Blood (serum) samples of participants were analyzed for serum creatinine and serum β2 microglobulin while their urine samples were analyzed for creatinine and albumin. Urine albumin creatinine ratio (UACR) was calculated from the results of the analyses.</p><p><strong> </strong></p><p><strong>RESULTS</strong></p><p>There was a very strong positive correlation of serum β2 microglobulin with serum creatinine (r=0.750; p=0.000) and UACR (r=0.775; p=0.000), respectively. Also, there was a very strong negative correlation between serum β2 microglobulin and eGFR (r=-0.866; p=0.000). UACR had the highest sensitivity and specificity as shown by receiver operating curve characteristics (ROC) analysis.</p><p><strong> </strong></p><p><strong>CONCLUSION</strong></p><p>In CKD, UACR and serum β2 microglobulin had the best diagnostic value. Periodic renal assessment of renal patients is mandatory as they may be affected by hidden renal dysfunction.</p>

scholarly journals Effects of the Soluble Guanylate Cyclase Stimulator Praliciguat in Diabetic Kidney Disease

2020 ◽  
Vol 16 (1) ◽  
pp. 59-69
Author(s):  
John P. Hanrahan ◽  
Ian H. de Boer ◽  
George L. Bakris ◽  
Phebe J. Wilson ◽  
James D. Wakefield ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Guanylate Cyclase ◽  
Diabetic Kidney Disease ◽  
Soluble Guanylate Cyclase ◽  
Creatinine Ratio ◽  
Primary Efficacy ◽  
Albumin Creatinine Ratio ◽  
Diabetic Kidney ◽  
Urine Albumin ◽  
Urine Albumin Creatinine Ratio

Background and objectivesImpaired nitric oxide signaling through soluble guanylate cyclase has been implicated in the pathophysiology of diabetic kidney disease. Praliciguat, a soluble guanylate cyclase stimulator that amplifies nitric oxide signaling, inhibited kidney inflammation and fibrosis in animal models.Design, setting, participants, & measurementsIn a phase 2 trial, 156 adults with type 2 diabetes, eGFR 30–75 ml/min per 1.73 m2, and urine albumin-creatinine ratio 200–5000 mg/g treated with renin-angiotensin system inhibitors were randomly allocated 1:1:1 to placebo, 20 mg praliciguat, or 40 mg praliciguat daily for 12 weeks. The primary efficacy and safety outcomes were change from baseline to weeks 8 and 12 in urine albumin-creatinine ratio and treatment-emergent adverse events, respectively. Other outcomes assessed were 24-hour ambulatory BP and metabolic parameters.ResultsOf 156 participants randomized, 140 (90%) completed the study. The primary efficacy analysis demonstrated a mean change from baseline in urine albumin-creatinine ratio of −28% (90% confidence interval, −36 to −18) in the pooled praliciguat group and −15% (−28 to 0.4) in the placebo group (difference −15%; −31 to 4; P=0.17). Between-group decreases from baseline to week 12 for praliciguat versus placebo were seen in mean 24-hour systolic BP (−4 mm Hg; −8 to −1), hemoglobin A1c (−0.3%; −0.5 to −0.03), and serum cholesterol (−10 mg/dl; −19 to −1). The incidence of treatment-emergent adverse events was similar in the pooled praliciguat and placebo groups (42% and 44%, respectively). Serious adverse events, events leading to study drug discontinuation, and events potentially related to BP lowering were reported at higher frequency in the 40-mg group but were similar in 20-mg and placebo groups.ConclusionsPraliciguat treatment for 12 weeks did not significantly reduce albuminuria compared with placebo in the primary efficacy analysis. Nonetheless, the observed changes in urine albumin-creatinine ratio, BP, and metabolic variables may support further investigation of praliciguat in diabetic kidney disease.Clinical Trial registry name and registration number:A Study to Evaluate the Soluble Guanylate Cyclase (sGC) Stimulator IW-1973 in Diabetic Nephropathy/Diabetic Kidney Disease as Measured by Albuminuria, NCT03217591

Abstract P602: Patiromer Decreased Aldosterone, Urine Albumin/Creatinine Ratio, and Blood Pressure in Patients with Chronic Kidney Disease and Hyperkalemia on RAAS Inhibitors: Results from OPAL-HK

Hypertension ◽  
2015 ◽  
Vol 66 (suppl_1) ◽  
Author(s):  
Matthew Weir ◽  
George Bakris ◽  
Coleman Gross ◽  
Martha Mayo ◽  
Dahlia Garza ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Plasma Renin ◽  
Creatinine Ratio ◽  
Phase 3 ◽  
Albumin Creatinine Ratio ◽  
Urine Albumin ◽  
Raas Inhibitors ◽  
Withdrawal Phase

Introduction: Elevated aldosterone (ALD) is associated with chronic kidney disease (CKD) and cardiovascular (CV) complications. Patiromer, a nonabsorbed potassium (K + )-binding polymer, decreases serum K + (sK + ) and may allow increased use of RAAS inhibitors (RAASi) in patients (pts) with CKD and hyperkalemia (HK). This analysis examined the effect of patiromer on ALD, urinary albumin/creatinine ratio (ACR), and blood pressure (BP) in pts with CKD on RAASi. Methods: OPAL-HK was a 2-part, phase 3 study in 243 CKD pts with sK + 5.1–<6.5 mEq/L on RAASi. Pts received patiromer for 4 wks (Part A); pts with moderate-severe HK at baseline (sK + ≥5.5 mEq/L) and sK + 3.8–<5.1 at Part A wk 4 continued on patiromer (n=55) or switched to placebo (n=52) in the 8-wk withdrawal phase (Part B). RAASi were stable prior to and during Part A. Changes in ALD, ACR, and systolic BP/diastolic BP (SBP/DBP) were analyzed. Results: After 4 wks of patiromer sK + , serum ALD and urine ALD/creatinine decreased, while plasma renin activity (PRA) was unchanged; SBP, DBP, and ACR also declined (Table). Mean±SE changes (ng/dL) in serum ALD from Part A wk 4 to Part B wk 4 and to Part B wk 8 were 4.6±1.6 (p<0.01) and 5.7±1.8 (p<0.01) in the placebo and 0.9±1.0 (p=NS) and 0.2±0.8 (p=NS) in the patiromer groups, respectively. Compared with Part A wk 4, SBP (mm Hg) was further reduced at Part B wk 4 (3.1±2.1, p=NS) and Part B wk 8 (5.4±1.9, p<0.01) with maintained improvement in ACR in patiromer pts. Conclusions: Patiromer reduced both sK + and ALD (independent of PRA) in CKD pts with HK on RAASi. ALD reductions correlated with lower BP and ACR. Reduction in sK + may have lowered ALD possibly improving BP and ACR.

scholarly journals Prevalence of Early Chronic Kidney Disease and Main Associated Factors in Spanish Population: Populational Study

2019 ◽  
Vol 8 (9) ◽  
pp. 1384 ◽  
Author(s):  
Carmen Expósito ◽  
Guillem Pera ◽  
Lluís Rodríguez ◽  
Ingrid Arteaga ◽  
Alba Martínez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Multivariate Logistic Regression Model ◽  
Creatinine Ratio ◽  
Multivariate Logistic Regression ◽  
Albumin Creatinine Ratio ◽  
Factors Associated ◽  
Urine Albumin ◽  
Primary Healthcare Centers

The aim of this study was to determine the prevalence of early chronic kidney disease (EKD) (stages 1 and 2) and the factors associated. This was a populational study including individuals from 18–75 years randomly selected from 18 Primary Healthcare centers in the area of Barcelonès Nord and Maresme (Catalunya, Spain). Variables: anamnesis, physical examination, blood pressure, and analysis. EKD was defined with by a glomerular filtration rate (GFR) ≥60 mL/min/1.73 m2 and albumin/creatinine ratio (ACR) ≥17 mg/g in men and ≥25 mg/g in women confirmed with two determinations. 2871 individuals: 43% men, mean age 55 years (19–75), 32.2% obese, 50.5% abdominal obesity, 21.1% hypertensive, and 10.6% diabetic. Prevalence of EKD: With one determination 157 individuals (5.5%), 110 men (9%) and 47 women (2.8%); with two determinations 109 individuals (3.8%), 85 men (7%), and 24 women (1.5%). Factors independently associated with the multivariate logistic regression model: Man (OR 3.35), blood pressure ≥ 135/85 mmHg (OR 2.29), BMI ≥ 30 kg/m2 (OR 2.48), glycemia ≥ 100 mg/dL (OR 1.73), smoker (OR 1.67) and age (OR 1.04). The prevalence varies if the diagnosis is established based on one or two analytical determinations, overestimated if only one determination is made and depends on the value chosen to define urine albumin excretion.

scholarly journals Comparison of urine albumin creatinine ratio with the pediatric index of mortality 2 score for prediction of pediatric intensive care unit outcomes

2021 ◽  
Author(s):  
Shifa Nismath ◽  
Suchetha S. Rao ◽  
B. S. Baliga ◽  
Vaman Kulkarni ◽  
Gayatri M. Rao
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Characteristic Curve ◽  
Pediatric Intensive Care ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Urine Albumin ◽  
Urine Albumin Creatinine Ratio ◽  
Pediatric Index Of Mortality

Abstract Background Predicting morbidity and mortality in a pediatric intensive care unit (PICU) is of extreme importance to make precise decisions for better outcomes. Aim We compared the urine albumin creatinine ratio (ACR) with the established PICU score, pediatric index of mortality 2 (PIM 2) for predicting PICU outcomes. Methods This cross-sectional study enrolled 67 patients admitted to PICU with systemic inflammatory response syndrome. Urine ACR was estimated on admission, and PIM 2 score was calculated. ACR was compared with PIM 2 for PICU outcome measures: the need for inotropes, development of multiple organ dysfunction syndrome (MODS), duration of PICU stay, and survival. Results Microalbuminuria was found in 77.6% of patients with a median ACR of 80 mg/g. ACR showed a significant association with the need for inotropes (p < 0.001), MODS (p = 0.001), and significant correlation to PICU stay (p 0.001, rho = 0.361). The area under the receiver operating characteristic curve for ACR (0.798) was comparable to that of PIM 2 (0.896). The cutoff value of ACR derived to predict mortality was 110 mg/g. The study subjects were divided into 2 groups: below cutoff and above the cutoff. Outcome variables, inotrope use, MODS, mortality, and PICU stay compared between these subgroups, were statistically significant. Conclusion ACR is a good predictor of PICU outcomes and is comparable to PIM 2 for mortality prediction.

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