Original InvestigationPathogenesis and Treatment of Kidney DiseaseDay-to-Day Variability in Spot Urine Albumin-Creatinine Ratio
Section snippets
Study Design
We performed a study between July 2007 and April 2010 at a metropolitan tertiary-care teaching hospital in Sydney, Australia, which was designed and reported using the STARD (Standards for Reporting of Diagnostic Accuracy) guidelines.13 The Sydney South West Area Health Service Ethics Review Committee approved this study, protocol number X06-0196.
Patient Recruitment and Consent
Patients were recruited from the hospital’s CKD and kidney transplantation clinics. Eligible individuals identified from an electronic database were
Patient Characteristics
Of the 570 patients from the hospital’s CKD outpatient clinics who were invited to participate in this study, 270 consented and were enrolled. Forty-two percent (n = 113) were excluded because they did not provide all required specimens, leaving 157 patients whose paired samples were analyzed (Fig 1). The baseline characteristics of those who completed the study were not significantly different from those who did not. Patient characteristics are listed in Table 1. More than two-thirds of the
Discussion
Albuminuria is a well-established marker of kidney damage and is predictive of cardiovascular morbidity, mortality, and progressive loss of kidney function.1, 2, 8 Thus, its measurement is important in the diagnosis and care of patients with kidney disease. Although several methods of measuring albumin excretion are available, each has its own limitations. Measurement of ACR in a spot urine sample is convenient for the patient, is less prone to collection errors compared with timed collections,
Acknowledgements
We thank Ms Georgia Whitman, Assoc Prof Josette Eris, Dr Paul Snelling, Assoc Prof Adrian Gillin, Dr Vicki Levidiotis, Dr Kate Wyburn, and Prof David Harris for assistance with patient recruitment. We are grateful to Dr Philip Clayton for expert statistical advice.
Support: This work was part of Dr Naresh’s doctoral work, which was supported by a Kidney Health Australia scholarship.
Financial Disclosure: The authors declare that they have no other relevant financial interests.
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Originally published online August 19, 2013.