ACR-Albumin creatinine ratio

ACR : albumin/creatinine ratio; BMI: body mass index; BP: blood pressure; BRAZLIPO: Brazilian Group for the Study of Inherited and Acquired Lipodys- trophies; CAD: coronary artery disease; CAN: cardiac autonomic neuropathy; CGL: congenital generalized lipodystrophy; cIMT: carotid intimal media thickness; cQT interval: corrected QT interval; EAT: epicardial adipose tissue; EF: ejection fraction; FFA: free fatty acids; GFR: glomerular filtration rate; HbA1c: glycated hemoglobin; HDL: high density lipoprotein; HF: high frequency; HOMA-IR: homeostasis model assessment-insulin resistance; HRV: heart rate variability; IGF-1: insulin growth factor 1; IVS: interventricular septum thickness; LF: low frequency; LV: left ventricle; LVH: left ventricular hypertrophy; LVMI: left ventricular mass index; NDS: neuropathy disability score; RPLV: relative thickness of the posterior wall of left ventricle; TAS: total amplitude spectrum; TSS: neuropathy total symptom score; T2DM: type 2 diabetes mellitus; us-CRP: ultra-sensitive C reactive protein; VLF: very low frequency.

ACR: Albumin creatinine ratio; AD: Alzheimer disease;; BMI: Body mass index; BP: Blood pressure; CHR: Cause specific hazard ratio; CI: Confidence interval; CKD: Chronic kidney disease; CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration; DBP: Diastolic blood pressure; DM: Diabetes mellitus; eGFR: Estimated glomerular filtration rate; FTD: Frontal temporal dementia; HMS: Health and Memory Study of Nord-Trøndelag County; HR: Hazard ratio; HTN: Hypertension; HUNT: The Health Study of Nord-Trøndelag; ICD- 10: International classification of diseases; LBD: Lewy body dementia; MA: Moderately increased albuminuria; MCI: Mild cognitive impairment; MI: Myocardial infarction; Mixed AD/VaD: Mixed Alzheimer ’ s Disease/vascular dementia; NO: Nitric oxide; NTNU: Norwegian University of Science and Technology; REK: Regional Committee for Medical and Health Research Ethics; SBP: Systolic blood pressure; SH: Subdistribution hazard; SHR: Subdistribution hazard ratio; SPSS: Statistical Package for the Social Sciences; VaD: Vascular dementia

24 h UA: 24-h urine albumin; ACE: Angiotensin converting enzyme; ACEI: Angiotensin converting enzyme inhibitor; ACR: Albumin-creatinine ratio; ARB: Angiotensin receptor blocker; CKD: Chronic kidney disease; CRF: Case report forms; CRP: C-reactive protein; DKD: Diabetic kidney disease; eGFR: Estimated glomerular filtration rate; EQ5D: Euroquol 5D; ESRD: End-stage renal disease; HbA1c: Glycated haemoglobin; ICMJE: International Committee of Medical Journal Editors; IgA: Immunoglobulin A; IRB: Institutional review board; MDRD: Modification of Diet in Renal Disease; miRNA: MicroRNA; MNSI: Michigan Neuropathy Screening Instrument; mRNA: Messenger RNA; NPRP: National Priorities Research Program; PTH: Parathyroid hormone; QNRF: Qatar National Research Fund; RAAS: Renin angiotensin aldosterone system; RCT: Randomised controlled trial; SBP: Systolic blood pressure; T2DM: Type 2 diabetes mellitus; TGF- β : Transforming growth factor β ; TIBC: Total iron binding capacity

ACR: Albumin: creatinine ratio; ALT: Alanine transaminase; AST: Aspartate Aminotransferase; BMI: Body mass index; CKD: Chronic kidney disease; CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration; Cr: Creatinine; CVD: Cardiovascular disease; ESRD: End stage renal disease; FPG: Fasting plasma glucose; GFR: Glomerular filtration rate; HbA1c: Glycated Haemoglobin; hs CRP: High sensitivity C- reactive protein; KDIGO: Kidney Disease Improving Global Outcomes; KDOQI: National Kidney Foundation ’ s Kidney Disease Outcome Quality Initiative; MDRD: Modification of Diet in Renal Disease Study; OR: Odd ratio; ORISCAV-LUX: Observation of Cardiovascular Risk Factors in Luxembourg; SPSS: Statistical Package for the Social Sciences; WC: Waist circumference; γ -GT: Gamma-glutamyl-transpeptidase

ACEi: angiotensin converting enzyme inhibitors; ACR: albumin creatinine ratio; ARB: angiotensin receptor blocker; ARE: arylesterase; AU: arbitrary unit; BIA: bioelectrical impedance analysis; BIVA: bioelectrical impedance vector analysis; BMI: body mass index; CAD: coronary artery disease; CEC: cholesterol efflux capacity; CerVD: cerebrovascular disease; CETP: cholesteryl ester transfer protein; CKD: chronic kidney disease; DEXA: dual-energy X-ray analysis; DPP-4i: dipeptydil peptidase 4 inhibitor; eGFR: estimated glomerular filtration rate; ETDRS: Early Treatment of Diabetic Retinopathy Study; GIP: glucose depend- ent insulinotropic peptide; GLP-1: glucagon like peptide 1; HDL: high density cholesterol; IL: interleukin; KDOQI: Kidney Disease Outcomes Quality Initiative; LDL: low density cholesterol; MACE: major adverse cardiovascular events; NYHA: New York Heart Association; PAD: peripheral arterial disease; PAI: plasmi- nogen activator inhibitor; PON1: paraoxonase 1; RCT: randomized controlled trial; SGLT2i: sodium glucose co-transporter inhibitor; SU: sulphonylurea; T2D: type 2 diabetes; TNF: tumor necrosis factor; ULN: upper limit of normal.

Objective: Elevated urine albumin to creatinine ratio (ACR) of >30 mg/gm is a widely agreed upon indica- tor of pathologic albuminuria in children. However, the most reliable specimen to measure ACR in chil- dren remains undefined. We assess the range and lim- its of upright and supine total albumin and ACR in healthy children. Methods: Healthy children age 6 - 18 years completed 24-hour and split upright and supine urine collections. Upright, supine and 24-hour protein, albumin and creatinine were measured. Pri- mary outcomes are range and variation in urine al- bumin by diurnal status, age, gender, BMI percentile and Tanner stage. Results: In healthy children, with mean age 12.9 year (sd 3.2), upright ACR was 2-fold greater than supine (13.9 vs 6.8 mg/gm, p = 0.02). The range of ACR was much greater in the upright (2 - 323 mg/gm) compared to the supine (1.7 - 76 mg/gm) samples. The average total 24-hour urine albumin was 8.4 mg (sd 9.8) and the mean ACR was 8.9 mg/gm (sd 11.7). The 24-hour albumin increased with age and Tanner stage, but this relationship was not significant after adjusting for BSA or urine creatinine. A supine or upright ACR of >30 mg/gm was found in 5.4% of each group. However, in all subjects with an elevated ACR on an individual upright or supine sample, a second 1st am ACR sample was normal. Conclusions: In healthy children there is a marked diurnal vari- ability in ACR with a higher value from a daytime sample compared to 1st morning specimen. Screening for pathologic albuminuria should always use a first morning urine specimen.

ACEI: angiotensin-converting enzyme inhibitor; ACR: albumin-to-creatinine ratio; ALT: alanine aminotransferase; ARB: angiotensin receptor blocker; AST: asparatate aminotransferase; BMI: body mass index; CCBs: calcium channel blockers; CI: confidence interval; CIMT: carotid intima media thickness; CT: computed tomography; CVD: cardiovascular disease; DBP: diastolic blood pressure; DPP4: dipeptidyl peptidase-4; eGFR: estimated glomerular filtration rate; GI: glycosidase inhibitor; GLP-1: glucagon-like peptide-1; GTP: glutamyl transpeptidase; HDL: high-density lipoprotein; JDS: Japan Diabetes Society; LDL: low-density lipoprotein; OHA: oral hypoglycemic agent; PDR: proliferative diabetic retinopathy; SBP: systolic blood pressure; SFA: subcutaneous fat area; TZD: thiazolidinedione; UA: uric acid; VFA: visceral fat area.

The baseline data included: detailed demographics; fi- nancial, sociological and health care related information; medical and family history including previously taken medications; and questionnaires related to quality of life, health behaviors, and physical activity. Height, weight, waist and hip width, resting blood pressure, and heart rate were collected. Laboratory parameters including complete blood count, serum uric acid, serum creatin- ine, serum cholesterol, serum calcium and phosphate, fasting blood glucose, high-sensitivity C-reactive protein (Hs-CRP), intact parathyroid hormone (iPTH), urine dipstick, albumin-to-creatinine ratio (ACR), 24-h urine protein, electrolytes, 12-lead surface electrocardiography, echocardiogram and lateral abdominal radiograph were collected for each participant.

Methods: Secondary data analyses of the NHANES 2011 – 2014 data of a nationally representative sample of 5907 participants 18 years and older, US citizens, and of Asian and White race. NHANES data included race (Asian vs. White), as well as other socio-demographic information and comorbidities. Urine albumin-to-creatinine ratio (ACR) categories and estimated glomerular filtration rate (eGFR) were used as indicators for CKD. Descriptive analyses using frequencies, means (standard deviations), and chi-square tests was first conducted, then multivariable logistic regression serial adjustment models were used to examine the associations between race/ethnicity, other socio-demographic factors (age, sex, education), and co-morbidities (obesity, diabetes, hypertension) with elevated ACR levels (A2 & A3 – CKD Stages 3 and 4 – 5, respectively) as well as reduced eGFR (G3a-G5 and G3b – G5 - CKD Stage 3 – 5).

ACR- Albumin to creatinine ratio; BUN – Blood urea nitrogen; CKD – Chronic Kidney disease; CKD-EPI – Chronic Kidney disease – Epidemiology Collaboration; CKDu – Chronic kidney disease of unknown aetiology; COPCORD – Community acquired program for the control of rheumatic disease; E-GFR – Estimated glomerular filtration rate; ESRD – End stage renal disease; IDMS – Isotope dilution mass spectroscope; JOABPEQ – Japanese orthopaedic association back pain evaluation questionnaire; MDRD – Modification of Diet in Renal disease; MOH – Ministry of Health; NCD – Non-communicable diseases; NCP – North Central Province; NSAID’s – Non-steroidal anti-inflammatory drugs; NWP – North Western Province; WHO – World Health Organization.

Over 26 million American adults have chronic kidney disease (CKD) [1], evidenced by estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m 2 or albumin- to-creatinine ratio (ACR) ≥ 30 mg/g. CKD is a substan- tial public health challenge given its high prevalence and association with adverse outcomes, including cardiovas- cular disease (CVD) incidence and all-cause mortality [2, 3]. Identifying factors that explain this increased risk may provide guidance on the development of in- terventions to reduce it.

ACR : urine albumin creatinine ratio; BMI: body mass index; CI: confidence interval; CIMT: carotid intima-media thickness; CKD: chronic kidney disease; CVD: cardiovascular disease; DHEA: dehydroepiandrosterone; DKD: diabetic kidney disease; E2: estradiol; eGFR: estimated glomerular filtration rate; FPG: fasting plasma glucose; FSH: follicle-stimulating hormone; HbA1c: hemo- globin A1c; HDL: high density lipoprotein; LDL: low density lipoprotein; LH: luteinizing hormone; OR: odds ratio; SCr: serum creatinine; SHBG: sex hormone binding globulin; TC: total cholesterol; TG: triglycerides; TT: total testosterone; T2DM: type 2 diabetes mellitus.

Methods/Design: The following electronic databases will be systematically searched from inception to January 2015 for relevant studies: CINAHL, EMBASE, MEDLINE, PubMed, Cochrane libraries and grey literature. Two independent reviewers will screen search results, extract data, select studies for inclusion and assess their quality. Studies including young adults (aged 18 to 40 years) with IGT containing any of the following CKD markers will be included: estimated glomerular filtration rate (eGFR), albumin creatinine ratio (ACR), protein creatinine ratio (PCR), serum creatinine (SCr) and creatinine clearance (CrCl) levels. Studies at any time period after diagnosis of IGT and with any length of follow-up will be included. The proportion of IGT participants reporting each outcome will be documented. Relative risks (RR) and odds ratios (OR) will be extracted or calculated from raw data. If possible, study results will be combined in a meta-analysis.

ACR : Albumin‑to‑creatinine ratio; ACEI: Angiotensin‑converting enzyme inhibitor; ARB: Angiotensin receptor blocker; ASCVD: Atherosclerotic cardio‑ vascular disease; CAC : Coronary artery calcification; CAD: Coronary artery disease; CKD: Chronic kidney disease; DBP: Diastolic blood pressure; eGFR: Esti‑ mated glomerular filtration rate; GLP‑1RA: Glucagon‑like peptide 1 receptor analogue; LDL: Low‑density lipoprotein; MACE: Major adverse cardiovascular events; PCE: Pooled Cohort Equations; PED: Peripheral endothelial dysfunc‑ tion; RH‑PAT: Reactive hyperemia‑peripheral arterial tonometry; RHI: Reactive hyperemia‑peripheral arterial tonometry index; SBP: Systolic blood pressure; SGLT2: sodium‑glucose cotransporter 2.

ACR : albumin-to-creatinine ratio; ALT: alanine aminotransferase; AST: aspartate aminotransferase; BMI: body mass index; CAD: coronary artery disease; CV: cardiovascular; eGFR: estimated glomerular filtration rate; EMPA: empagliflozin; FBG: fasting blood glucose; HbA1c: hemoglobin A1c; HDL: high-density lipo- protein; HOMA-IR: homeostatic model assessment of insulin resistance; hsCRP: high sensitivity C-reactive protein; IRI: immunoreactive insulin; LDL: low- density lipoprotein; RLP-C: remnant-like particle cholesterol; SGLT2: sodium– glucose cotransporter 2 inhibitor; γGTP: gamma-glutamyl transpeptidase.

ACR: Albuminuria-to-creatinine ratio; ADVANCE: Action in diabetes and vascular disease: preterax and diamicron MR controlled evaluation study; AER: Albumin excretion rate; BMI: Body mass index; BP: Blood pressure; CI: Confidence interval; CKD: Chronic kidney disease; CKD-EPI: Chronic kidney disease epidemiology; Cr: Creatinine; CV: Cardiovascular; D & B: Downs and black; DKD: Diabetic kidney disease; eGFR: Estimated glomerular filtration rate; ESRD: End-stage renal disease; ET-A: Endothelin receptor type A; FMV: First morning void; GFR: Glomerular filtration rate; GLP-1: Glucagon like peptide-1; HbA1c: Hemoglobin A1c; HR: Hazard ratio; IDNT: Irbesartan Diabetic Nephropathy Trial; JDDM: Japan diabetes clinical data management study; JSN: Japanese society of nephrology; MACE: Major adverse coronary event; MDRD: Modification of diet in renal disease; NHANES III: Third National Health and Nutrition Examination Survey; NICE: National Institute for Health and Care Excellence; ONTARGET: Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial; ORIGIN: Outcome reduction with initial glargine intervention trial; PAR: Peripheral artery revascularization; PICOS: Population, intervention, comparator, outcomes, and study type; PRISMA: Preferred reporting items for systematic reviews and meta-analyses; RAAS: Renin angiotensin aldosterone system;

ACR: Albumin to creatinine ratio; ANOVA: Analysis of variance; BMI: Body mass index; CAS: Coronary artery stenosis; CI: Confidence interval; CRONOS- ADM: Coronary CT angiography evaluation for clinical outcome in asymptomatic patients with type 2 diabetes; CT: Computed tomography; CVD: Cardiovascular disease; DBP: Diastolic blood pressure; DPP-IV: Dipeptidyl peptidase IV; ECG: Electrocardiography; FPG: Fasting plasma glucose; GFR: Glomerular filtration rate; HDL: High density lipoprotein; HOMA- IR: Homeostasis model assessment of insulin resistance; LDL: Low density lipoprotein; NCEP-ATP III: National cholesterol education program adult treatment panel III; OR: odds ratio; PPG: Postprandial plasma glucose; SBP: Systolic blood pressure; TyG index: Triglyceride-to-glucose index; WC: Waist circumference;

ABI: ankle-brachial index; ACR: albumin-to-creatinine ratio; ADA: American Diabetes Association; A1C: hemoglobin A1C; AHA/ACC: American Heart Association/American College of Cardiology; AHI: apnea hypopnea index; AMI: acute myocardial infarct; ARR: absolute risk reduction; ASCVD: athero- sclerotic cardiovascular disease; CAC: coronary artery calcium score; CHD: coronary heart disease; CMIT: carotid intima-media thickness; CNHSS: China National HbA1c Surveillance System; CI: confidence interval; CRP: C-reactive protein; CV: cardiovascular; CVD: cardiovascular disease; CKD: chronic kidney disease; EBCT: electron-beam computed tomography; ECG: eletrocardiogram; ED: erectile dysfunction; FMD: flow mediated dilation; FPG: fasting plasma glucose; FRS: framingham risk score; GFR: glomerular filtration rate; HDLc: high density lipoprotein; HR: hazard ratio; hs-CRP: high sensitivity c-reactive protein; IL-6: interleukin 6; ICAM: intercellular adhesion molecule; LDL-c: low density cholesterol; MDCT: multi-detector computed tomography; MetS: metabolic syndrome; MPI: adenosine-stress myocardial perfusion imaging; NAFLD: non-alcoholic fatty liver disease; NCEP-ATP III: National Cholesterol Education Program-Adult Treatment Panel III; NHANES III: National Health and Nutrition Examination Survey; OR: odds-ratio; OSA: sleep apnea; PAI-1: plasminogen activator inhibitor-1; ROC: receiver operating characteristic; RR: relative risk; SBP: systolic blood pressure; T1DM: type 1 diabetes; T2DM: type 2 diabetes; VEGF: vascular endothelial growth factor; UK: United Kingdom; UKPDS-RE: United Kingdom Prospective Diabetes Study Risk Engine; VCAM: vascular cell adhesion molecule; WHO: World health Organization.

ACEI: Angiotensin-converting enzyme inhibitor; ACR: Albumin-to-creatinine ratio; AE: Adverse event; ARB: Angiotensin II receptor blocker; CHM: Chinese herbal medicine; CKD: Chronic kidney disease; CRF: Case report form; CRO: Clinical research organization; DKD: Diabetic kidney disease; ESKD: End- stage kidney disease; GFR: Glomerular filtration rate; ITT: Intention-to-treat set; KDIGO: Kidney Disease Improving Global Outcomes; MAlb: Urinary microalbumin; NKF-KDOQI: National Kidney Foundation Kidney Disease Outcomes Quality Initiative; PPS: Per-protocol analysis set; RAAS: Renin – angiotensin – aldosterone system; SAS: Safety analysis set; SCr: Serum creatinine; SOP: Standardized operation practice; TSF: Tangshan Formula; UAER: Urinary microalbumin excretion rate

We received less than 80% for the initial response rate (n = 57, 73.1%), however our paired response rate was 94.7% (n = 54/57). There may be a number of sources of bias in this investigation. Firstly, the practices participat- ing in this study are pre-selected by the researchers and may not be representative of the wider population and we do not report on non-responders. The study does not compare confidence and knowledge to clinical out- comes for patients, namely, their enablement [34] or awareness of their diagnosis [35], and so cannot associ- ate high scores with improved care. We also do not measure competence because competence includes knowledge, skills and attitudes [36]. It is possible that treatment thresholds or the measures of renal function or for testing proteinuria may vary between health sys- tems; however these aspects of the questionnaire can be adapted to keep abreast of a changing evidence base and practice. For example, the use of total protein creatinine ratio rather than albumin and creatinine ratio (ACR) as a proteinuria test; or the use of another method of meas- uring renal function.