Nephrology-Dialysis-Transplantation, University of Liège, Liège, Belgium.
Department of Clinical Chemistry, University of Liège, Liège, Belgium.
Clin Chem Lab Med. 2022 May 5;60(7):1064-1072. doi: 10.1515/cclm-2022-0049. Print 2022 Jun 27.
Severity of chronic kidney disease is defined by glomerular filtration rate (GFR) and albuminuria (ACR) by the KDIGO and are related to cardiovascular outcomes and end-stage-kidney-failure. However, proteinuria (PCR) is more often available than ACR in records. Recently, equations were developed to estimate ACR from PCR. We investigated their performances in our population.
In the academic medical hospital of Liège, we retrospectively analysed same day measurement of ACR and PCR and staged them according to the KDIGO A1-A2-A3 categories. Analyser Roche Cobas (R) gathered 2,633 urinalysis (May 2018-May 2019) and analyser Abbott Alinity (A) 2,386 urinalysis (May 2019-March 2020). We compared the KDIGO staging of mACR and eACR obtained from Weaver's and Sumida's equations.
Median age was 63 [52;71]/64 [53;72] years old, 43/42% were female; 78/74% had diabetes; proportion of mACR-A1 was 65.6%/64.2%, A2 was 25.5%/25.5% and A3 was 8.8%/10.3% (Method R/A, respectively). Both equations gave similar distribution of KDIGO staging of eACR. Overall agreements were higher than 88% regardless of the analyser or of the equation. Performances in between equations were equivalent according to the multi-level AUC (multinomial logistic regression model).
Good concordance was observed between mACR and eACR regardless of the equation or of the analyser. No patient with an A3-measured ACR was estimated within the KDIGO A1 category. Though ACR should be measured when clinically needed, it may be reasonably estimated from the PCR through these equations, for epidemiologic retrospective studies or research purposes.
慢性肾脏病的严重程度由肾小球滤过率（GFR）和白蛋白尿（ACR）定义，由 KDIGO 定义，并与心血管结局和终末期肾病衰竭相关。然而，在记录中，蛋白尿（PCR）比 ACR 更常见。最近，已经开发了一些方程来从 PCR 估计 ACR。我们在我们的人群中研究了它们的性能。
在列日学术医学中心，我们回顾性分析了同一天的 ACR 和 PCR 测量值，并根据 KDIGO A1-A2-A3 类别对其进行分期。罗氏 Cobas（R）分析仪收集了 2633 次尿液分析（2018 年 5 月至 2019 年 5 月），雅培 Alinity（A）分析仪收集了 2386 次尿液分析（2019 年 5 月至 2020 年 3 月）。我们比较了 Weaver 和 Sumida 方程得出的 mACR 和 eACR 的 KDIGO 分期。
中位年龄为 63 [52；71]/64 [53；72] 岁，43/42%为女性；78/74%患有糖尿病；mACR-A1 的比例分别为 65.6%/64.2%，A2 为 25.5%/25.5%，A3 为 8.8%/10.3%（方法 R/A）。两种方程得出的 eACR 的 KDIGO 分期分布相似。无论分析仪或方程如何，总一致性均高于 88%。根据多级 AUC（多项逻辑回归模型），方程之间的性能相当。
无论方程或分析仪如何，mACR 和 eACR 之间观察到良好的一致性。没有患者的 A3 测量 ACR 被估计在 KDIGO A1 类别内。虽然在临床上需要时应测量 ACR，但可以通过这些方程从 PCR 合理估计，用于流行病学回顾性研究或研究目的。
