Charlotte Robinson

DocwireNews

Albuminuria is known as a leading diagnostic and prognostic marker of diabetic chronic kidney disease. However, its day-to-day variability has not been sufficiently considered, so Natasha Rasaratnam, MD, and other researchers conducted a cross-sectional analysis to quantify the within-individual variability of albuminuria in patients with type 2 diabetes (T2D) to help guide clinical albuminuria monitoring.&nbsp;The study included individuals who took part in the Progression of Diabetic Complications cohort study and had T2D. There were 826 study participants, 64.9% of whom were male; median age was 67.1 years (interquartile range, 60.3-72.4). To examine the variability of urinary albumin-creatinine ratio (UACR), four spot urine samples were collected within 4 weeks for measurement. &nbsp;There was a high variability of UACR within individuals (coefficient of variation, 48.8%; 95% limits of random variation found a repeated UACR to be as high/low as 3.78/0.26 times the first). When a single-collection UACR increased from 2 to 5&#8197;mg/mmol, the probability that UACR increased by at least 30% was only 50%; this rose to 97% when two samples were taken at each time point. The ranges of diagnostic uncertainty were 2.0-4.0&#8197;mg/mmol after an initial UACR test, which narrowed to 2.4-3.2 and 2.7-2.9&#8197;mg/mmol for the mean of two and three collections, respectively.&nbsp;&nbsp;Female sex and moderately increased albuminuria corresponded with higher within-individual UACR variability. Reduced estimated glomerular filtration rate and treatment with sodium-glucose cotransporter 2 inhibitor, angiotensin-converting enzyme inhibitor, or angiotensin receptor blocker correlated with lower within-individual UACR variability.&nbsp;Taking multiple urine samples to measure UACR may help with monitoring changes over time in clinical and research settings. However, this approach may not be necessary for diagnosing albuminuria.&nbsp;&nbsp;Source: <a href="https://doi.org/10.1053/j.ajkd.2023.12.018" target="_blank" rel="noopener">American Journal of Kidney Diseases</a>

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Variability of UACR in Patients With T2D

Part of NephTimes Diseases and Conditions

Diabetes and Hypertension

Researchers conducted an analysis to quantify the within-individual variability of albuminuria in patients with type 2 diabetes.

Variability of UACR in Patients With T2D 

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