ACR: Albumincreatinineratio; 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
Objective: Elevated urine albumin to creatinineratio (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.
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-creatinineratio (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-creatinineratio (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 creatinineratio; 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) , evidenced by estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m 2 or albumin- to-creatinineratio (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.
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), albumincreatinineratio (ACR), protein creatinineratio (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: Albuminuria-to-creatinineratio; 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;
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  or awareness of their diagnosis , and so cannot associ- ate high scores with improved care. We also do not measure competence because competence includes knowledge, skills and attitudes . 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 creatinineratio rather than albumin and creatinineratio (ACR) as a proteinuria test; or the use of another method of meas- uring renal function.