Barska Iga, Mikołajczyk Melania, Paradowski Marek
Zakład Diagnostyki Laboratoryjnej i Biochemii Klinicznej, Uniwersytet Medyczny w Łodzi.
Pol Merkur Lekarski. 2013 May;34(203):255-8.
Urinary albumin excretion is an established risk factor for renal and cardiovascular events. Measurement of albumin in the urine daily collection is the gold standard in assessing albuminuria. The 24-hour urine collection is cumbersome procedure that generates a lot of mistakes, therefore other methods have been proposed. The aim of the study was to compare the assessment of albuminuria in the 24-hour urine collection and in the second morning urine sample as well as to determine UACR.
The study included 32 patients, from whom the daily and the second morning urine samples were collected. In both samples, the albumin and creatinine concentrations were determined and the urinary albumin: creatinine ratio (UACR) was calculated.
An excellent correlation between the UACR determined from the 24-hour urine collection and the other portion of the second morning sample was obtained within a wide range of albuminuria values (r = 0.9825). Furthermore, a better correlation between the same characteristics was obtained in urine of patients with normoalbuminuria when UACR did not exceed 30 mg/g creatinine (r = 0.9771). Above this value, the correlation was slightly lower for micro- and macroalbuminuria and equalled 0.9249 and 0.9332, respectively.
On the basis of the obtained results it can be concluded that the second morning urine sample with the determination of UACR is a good alternative to the 24-hour urine collection and the first morning urine sample which are burdened with a preanalytical error.
尿白蛋白排泄是肾脏和心血管事件的既定危险因素。每日收集尿液测量白蛋白是评估蛋白尿的金标准。24小时尿液收集是一个繁琐的过程，会产生很多错误，因此人们提出了其他方法。本研究的目的是比较24小时尿液收集和次日晨尿样本中蛋白尿的评估情况，并确定尿白蛋白肌酐比值（UACR）。
该研究纳入了32名患者，收集了他们的每日尿液样本和次日晨尿样本。在这两个样本中，测定了白蛋白和肌酐浓度，并计算了尿白蛋白：肌酐比值（UACR）。
在广泛的蛋白尿值范围内，24小时尿液收集测定的UACR与次日晨尿样本的另一部分之间具有极好的相关性（r = 0.9825）。此外，当UACR不超过30 mg/g肌酐时，在正常白蛋白尿患者的尿液中，相同特征之间的相关性更好（r = 0.9771）。高于此值，微量白蛋白尿和大量白蛋白尿的相关性略低，分别为0.9249和0.9332。
根据所得结果可以得出结论，测定UACR的次日晨尿样本是24小时尿液收集和晨尿样本的良好替代方法，后两者存在分析前误差。
