Spot Urine Estimations Are Equivalent to 24-Hour Urine Assessments of Urine Protein Excretion for Predicting Clinical Outcomes
Background. The use of spot urine protein to creatinine ratios in estimating 24 hr urine protein excretion rates for diagnosing and managing chronic kidney disease (CKD) predated the standardization of creatinine assays. The comparative predictive performance of spot urine ratios and 24 hr urine col...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2015/156484 |
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| author | Boon Wee Teo Ping Tyug Loh Weng Kin Wong Peh Joo Ho Kwok Pui Choi Qi Chun Toh Hui Xu Sharon Saw Titus Lau Sunil Sethi Evan J. C. Lee |
| author_facet | Boon Wee Teo Ping Tyug Loh Weng Kin Wong Peh Joo Ho Kwok Pui Choi Qi Chun Toh Hui Xu Sharon Saw Titus Lau Sunil Sethi Evan J. C. Lee |
| author_sort | Boon Wee Teo |
| collection | DOAJ |
| description | Background. The use of spot urine protein to creatinine ratios in estimating 24 hr urine protein excretion rates for diagnosing and managing chronic kidney disease (CKD) predated the standardization of creatinine assays. The comparative predictive performance of spot urine ratios and 24 hr urine collections (of albumin or protein) for the clinical outcomes of CKD progression, end-stage renal disease (ESRD), and mortality in Asians is unclear. We compared 4 methods of assessing urine protein excretion in a multiethnic population of CKD patients. Methods. Patients with CKD (n=232) provided 24 hr urine collections followed by spot urine samples the next morning. We created multiple linear regression models to assess the factors associated with GFR decline (median follow-up: 37 months, IQR 26–41) and constructed Cox proportional-hazards models for predicting the combined outcome of ESRD and death. Results. The linear regression models showed that 24 hr urine protein excretion was most predictive of GFR decline but all other methods were similar. For the combined outcomes of ESRD and death, the proportional hazards models had similar predictive performance. Conclusions. We showed that all methods of assessments were comparable for clinical end-points, and any method can be used in clinical practice or research. |
| format | Article |
| id | doaj-art-b3c1d827e4714b38861effa0cfc40ae4 |
| institution | Kabale University |
| issn | 2090-214X 2090-2158 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-b3c1d827e4714b38861effa0cfc40ae42025-02-03T01:33:23ZengWileyInternational Journal of Nephrology2090-214X2090-21582015-01-01201510.1155/2015/156484156484Spot Urine Estimations Are Equivalent to 24-Hour Urine Assessments of Urine Protein Excretion for Predicting Clinical OutcomesBoon Wee Teo0Ping Tyug Loh1Weng Kin Wong2Peh Joo Ho3Kwok Pui Choi4Qi Chun Toh5Hui Xu6Sharon Saw7Titus Lau8Sunil Sethi9Evan J. C. Lee10Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Level 10 NUHS Tower Block, 119228, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Level 10 NUHS Tower Block, 119228, SingaporeNational University Health System, 119228, SingaporeDepartment of Statistics and Applied Probability, Faculty of Science, National University of Singapore, 119228, SingaporeDepartment of Statistics and Applied Probability, Faculty of Science, National University of Singapore, 119228, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Level 10 NUHS Tower Block, 119228, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Level 10 NUHS Tower Block, 119228, SingaporeDepartment of Laboratory Medicine, National University Health System, 119228, SingaporeDepartment of Medicine, National University Health System, 119228, SingaporeDepartment of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, 119228, SingaporeDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Level 10 NUHS Tower Block, 119228, SingaporeBackground. The use of spot urine protein to creatinine ratios in estimating 24 hr urine protein excretion rates for diagnosing and managing chronic kidney disease (CKD) predated the standardization of creatinine assays. The comparative predictive performance of spot urine ratios and 24 hr urine collections (of albumin or protein) for the clinical outcomes of CKD progression, end-stage renal disease (ESRD), and mortality in Asians is unclear. We compared 4 methods of assessing urine protein excretion in a multiethnic population of CKD patients. Methods. Patients with CKD (n=232) provided 24 hr urine collections followed by spot urine samples the next morning. We created multiple linear regression models to assess the factors associated with GFR decline (median follow-up: 37 months, IQR 26–41) and constructed Cox proportional-hazards models for predicting the combined outcome of ESRD and death. Results. The linear regression models showed that 24 hr urine protein excretion was most predictive of GFR decline but all other methods were similar. For the combined outcomes of ESRD and death, the proportional hazards models had similar predictive performance. Conclusions. We showed that all methods of assessments were comparable for clinical end-points, and any method can be used in clinical practice or research.http://dx.doi.org/10.1155/2015/156484 |
| spellingShingle | Boon Wee Teo Ping Tyug Loh Weng Kin Wong Peh Joo Ho Kwok Pui Choi Qi Chun Toh Hui Xu Sharon Saw Titus Lau Sunil Sethi Evan J. C. Lee Spot Urine Estimations Are Equivalent to 24-Hour Urine Assessments of Urine Protein Excretion for Predicting Clinical Outcomes International Journal of Nephrology |
| title | Spot Urine Estimations Are Equivalent to 24-Hour Urine Assessments of Urine Protein Excretion for Predicting Clinical Outcomes |
| title_full | Spot Urine Estimations Are Equivalent to 24-Hour Urine Assessments of Urine Protein Excretion for Predicting Clinical Outcomes |
| title_fullStr | Spot Urine Estimations Are Equivalent to 24-Hour Urine Assessments of Urine Protein Excretion for Predicting Clinical Outcomes |
| title_full_unstemmed | Spot Urine Estimations Are Equivalent to 24-Hour Urine Assessments of Urine Protein Excretion for Predicting Clinical Outcomes |
| title_short | Spot Urine Estimations Are Equivalent to 24-Hour Urine Assessments of Urine Protein Excretion for Predicting Clinical Outcomes |
| title_sort | spot urine estimations are equivalent to 24 hour urine assessments of urine protein excretion for predicting clinical outcomes |
| url | http://dx.doi.org/10.1155/2015/156484 |
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