Division of Nephrology, Faculty of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan.
J Clin Lab Anal. 2013 Jul;27(4):333-8. doi: 10.1002/jcla.21608.
Since the degree and increase of albuminuria predict cardiovascular and renal diseases even within the range of normoalbuminuria. The high-performance liquid chromatography (HPLC) assay has been reported as a useful tool for earlier detection of microalbuminuria than turbidimetric immunoassay (TIA) in diabetes but has not been evaluated for other common diseases that caused chronic kidney disease (CKD).
We measured albumin in spot urine by TIA and HPLC assay in 119 patients with diabetes, hypertension, IgA nephropathy in complete remission, or autosomal-dominant polycystic kidney disease whose dipstick screening tests were negative.
There were significant correlations (r = 0.946) between TIA and HPLC assay, and the ratios of urine albumin/creatinine (ACR) measured by HPLC assay were always higher than those measured by TIA. The value of microalbuminuria was highest in IgA nephropathy patients, and higher in diabetic patients with hypertension than in those without hypertension. Fifty-one patients were classified as having normoalbuminuria and 42 as having microalbuminuria by both TIA and HPLC assay. However, 26 patients (21.8%) were classified having as normoalbuminuria by TIA but microalbumnuria by HPLC assay. Three of these patients were reclassified as microalbuminuria by both assays within 1 year.
These results suggest that ACR measurements by HPLC assay are better than TIA for early detection and monitoring of microalbuminuria in patients with diabetes and hypertension.
由于白蛋白尿的程度和增加即使在正常白蛋白尿范围内也可以预测心血管和肾脏疾病。高效液相色谱（HPLC）分析已被报道为比浊免疫测定（TIA）更早检测微量白蛋白尿的有用工具，尤其是在糖尿病中，但尚未在其他引起慢性肾病（CKD）的常见疾病中进行评估。
我们对 119 例糖尿病、高血压、完全缓解的 IgA 肾病或常染色体显性多囊肾病患者的随机尿液用 TIA 和 HPLC 分析检测白蛋白，这些患者的尿试纸筛选检测均为阴性。
TIA 和 HPLC 分析之间存在显著相关性（r = 0.946），并且 HPLC 分析测量的尿白蛋白/肌酐（ACR）比值始终高于 TIA 测量的比值。微量白蛋白尿的数值在 IgA 肾病患者中最高，在合并高血压的糖尿病患者中高于无高血压的患者。51 例患者通过 TIA 和 HPLC 分析均被归类为正常白蛋白尿，42 例患者被归类为微量白蛋白尿。然而，26 例患者（21.8%）通过 TIA 归类为正常白蛋白尿，但通过 HPLC 分析归类为微量白蛋白尿。其中 3 例在 1 年内被重新归类为微量白蛋白尿。
这些结果表明，HPLC 分析的 ACR 测量对于糖尿病和高血压患者微量白蛋白尿的早期检测和监测优于 TIA。
