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 co...
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Hindawi Publishing Corporation
2015
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306405/ |
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pubmed-43064052015-02-03 Spot Urine Estimations Are Equivalent to 24-Hour Urine Assessments of Urine Protein Excretion for Predicting Clinical Outcomes Teo, Boon Wee Loh, Ping Tyug Wong, Weng Kin Ho, Peh Joo Choi, Kwok Pui Toh, Qi Chun Xu, Hui Saw, Sharon Lau, Titus Sethi, Sunil Lee, Evan J. C. Research Article 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. Hindawi Publishing Corporation 2015 2015-01-08 /pmc/articles/PMC4306405/ /pubmed/25649135 http://dx.doi.org/10.1155/2015/156484 Text en Copyright © 2015 Boon Wee Teo et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Teo, Boon Wee Loh, Ping Tyug Wong, Weng Kin Ho, Peh Joo Choi, Kwok Pui Toh, Qi Chun Xu, Hui Saw, Sharon Lau, Titus Sethi, Sunil Lee, Evan J. C. |
| spellingShingle |
Teo, Boon Wee Loh, Ping Tyug Wong, Weng Kin Ho, Peh Joo Choi, Kwok Pui Toh, Qi Chun Xu, Hui Saw, Sharon Lau, Titus Sethi, Sunil Lee, Evan J. C. Spot Urine Estimations Are Equivalent to 24-Hour Urine Assessments of Urine Protein Excretion for Predicting Clinical Outcomes |
| author_facet |
Teo, Boon Wee Loh, Ping Tyug Wong, Weng Kin Ho, Peh Joo Choi, Kwok Pui Toh, Qi Chun Xu, Hui Saw, Sharon Lau, Titus Sethi, Sunil Lee, Evan J. C. |
| author_sort |
Teo, Boon Wee |
| title |
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_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_sort |
spot urine estimations are equivalent to 24-hour urine assessments of urine protein excretion for predicting clinical outcomes |
| 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. |
| publisher |
Hindawi Publishing Corporation |
| publishDate |
2015 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306405/ |
| _version_ |
1613180735939674112 |