Albuminuria is rapidly gaining recognition as a marker of the presence and of the progression of chronic kidney disease (CKD). In a new study, Naresh et al. attempt to define cut-off values for percentage change in urinary albumin:creatinine ratio that reflect changes in CKD status rather than random biological variation.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Naresh, C. N., Hayen, A., Weening, A., Craig, J. C. & Chadban, S. J. Day-to-day variability in spot urine albumin-creatinine ratio. Am. J. Kidney. Dis. http://dx.doi.org/10.1053/j.ajkd.2013.06.016.
Levey, A. S. et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 80, 17–28 (2011).
Mosca, A. et al. Biological variability of albumin excretion rate and albumin-to-creatinine ratio in hypertensive type 2 diabetic patients. Clin. Chem. Lab. Med. 41, 1229–1233 (2003).
Lambers Heerspink, H. J., Brinkman, J. W., Bakker, S. J. L., Gansevoort, R. T. & de Zeeuw, D. Update on microalbuminuria as a biomarker in renal and cardiovascular disease. Curr. Opinion Nephrol. Hypertens. 15, 631–636 (2006).
Lambers Heerspink, H. J. et al. Albuminuria assessed from first-morning-void urine samples versus 24-h urine collections as a predictor of cardiovascular morbidity and mortality. Am. J. Epidemiol. 168, 897–905 (2008).
National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am. J. Kidney Dis. 39 (Suppl. 1), S1–S266 (2002).
Johnson, D. W. et al. Chronic kidney disease and measurement of albuminuria or proteinuria: a position statement. Med. J. Aust. 197, 224–225 (2012).
Bland, J. M. & Altman, D. G. Measuring agreement in method comparison studies. Stat. Methods Med. Res. 8, 135–160 (1999).
Armbruster, D. A. & Pry, T. Limit of blank, limit of detection and limit of quantitation. Clin. Biochem. Rev. 29 (Suppl. 1), S49–S52 (2008).
Author information
Authors and Affiliations
Ethics declarations
Competing interests
The author declares no competing financial interests.
Rights and permissions
About this article
Cite this article
Bakker, S. Defining clinical cut-offs for albumin:creatinine ratio. Nat Rev Nephrol 9, 710–712 (2013). https://doi.org/10.1038/nrneph.2013.233
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrneph.2013.233