BACKGROUND AND OBJECTIVES: Albuminuria is regarded a sensitive measure of progression of glomerular disease. This study was undertaken in patients who had systemic lupus erythematosus glomerulonephritis (n = 57) and were followed in the Ohio SLE Study to determine whether measuring albuminuria offered clinical advantages over that of total proteinuria. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Twenty-four-hour urine collections (n = 127) were obtained at baseline and annually for measurement of microalbumin, total protein, and creatinine. RESULTS: There was a strong linear relationship between microalbumin-creatinine and protein-creatinine ratios over the entire range of protein-creatinine ratios; however, in the protein-creatinine ratio range 0.0 to 0.3, as the protein-creatinine ratio increased, the microalbumin-protein ratio increased much more than the protein-creatinine ratio. Also, the greater the protein-creatinine ratio, the greater was the evidence for nonselective proteinuria (protein-creatinine ratio--microalbumin-creatinine ratio). CONCLUSIONS: For the diagnosis of proteinuria renal flare, measuring albuminuria offers no advantage over measuring total proteinuria because changes in protein-creatinine and microalbumin-creatinine ratios are highly correlated over the designated ranges for systemic lupus erythematosus glomerulonephritis proteinuric flares. In those with normal-range proteinuria, subsequent changes in microalbumin-protein ratio might be a better forecaster of renal flare than changes in protein-creatinine or microalbumin-creatinine ratio. High protein-creatinine ratios are associated with evidence of nonselective proteinuria, which may increase the nephrotoxicity of proteinuria. Thus, using high-threshold criteria for systemic lupus erythematosus flare (allowing greater proteinuria increase before flare is declared) may expose the kidney to greater nephrotoxicity than using the low-threshold criteria for systemic lupus erythematosus flare.
BACKGROUND AND OBJECTIVES:Albuminuria is regarded a sensitive measure of progression of glomerular disease. This study was undertaken in patients who had systemic lupus erythematosus glomerulonephritis (n = 57) and were followed in the Ohio SLE Study to determine whether measuring albuminuria offered clinical advantages over that of total proteinuria. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Twenty-four-hour urine collections (n = 127) were obtained at baseline and annually for measurement of microalbumin, total protein, and creatinine. RESULTS: There was a strong linear relationship between microalbumin-creatinine and protein-creatinine ratios over the entire range of protein-creatinine ratios; however, in the protein-creatinine ratio range 0.0 to 0.3, as the protein-creatinine ratio increased, the microalbumin-protein ratio increased much more than the protein-creatinine ratio. Also, the greater the protein-creatinine ratio, the greater was the evidence for nonselective proteinuria (protein-creatinine ratio--microalbumin-creatinine ratio). CONCLUSIONS: For the diagnosis of proteinuria renal flare, measuring albuminuria offers no advantage over measuring total proteinuria because changes in protein-creatinine and microalbumin-creatinine ratios are highly correlated over the designated ranges for systemic lupus erythematosus glomerulonephritis proteinuric flares. In those with normal-range proteinuria, subsequent changes in microalbumin-protein ratio might be a better forecaster of renal flare than changes in protein-creatinine or microalbumin-creatinine ratio. High protein-creatinine ratios are associated with evidence of nonselective proteinuria, which may increase the nephrotoxicity of proteinuria. Thus, using high-threshold criteria for systemic lupus erythematosus flare (allowing greater proteinuria increase before flare is declared) may expose the kidney to greater nephrotoxicity than using the low-threshold criteria for systemic lupus erythematosus flare.
Authors: D A Isenberg; A Rahman; E Allen; V Farewell; M Akil; I N Bruce; D D'Cruz; B Griffiths; M Khamashta; P Maddison; N McHugh; M Snaith; L S Teh; C S Yee; A Zoma; C Gordon Journal: Rheumatology (Oxford) Date: 2005-04-06 Impact factor: 7.580
Authors: Brad H Rovin; Huijuan Song; Dan J Birmingham; Lee A Hebert; Chack Yung Yu; Haikady N Nagaraja Journal: J Am Soc Nephrol Date: 2004-12-15 Impact factor: 10.121
Authors: Hermine I Brunner; Gaurav Gulati; Marisa S Klein-Gitelman; Kelly A Rouster-Stevens; Lori Tucker; Stacey P Ardoin; Karen B Onel; Rylie Mainville; Jessica Turnier; Pinar Ozge Avar Aydin; David Witte; Bin Huang; Michael R Bennett; Prasad Devarajan Journal: Pediatr Nephrol Date: 2018-08-29 Impact factor: 3.714
Authors: Michiko Suzuki; Kristina Wiers; Elizabeth B Brooks; Kenneth D Greis; Kathleen Haines; Marisa S Klein-Gitelman; Judyann Olson; Karen Onel; Kathleen M O'Neil; Earl D Silverman; Lori Tucker; Jun Ying; Prasad Devarajan; Hermine I Brunner Journal: Pediatr Res Date: 2009-05 Impact factor: 3.756