Correlation Between 24-Hour Urine Protein and Random Urine Protein-Creatinine Ratio | oneAMYLOIDOSISvoice
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Correlation Between 24-Hour Urine Protein and Random Urine Protein-Creatinine Ratio in Amyloid Light-Chain Amyloidosis

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source: Kidney Medicine

year: 2022

authors: Lisa Mendelson, Vaishali Sanchorawala, Lawreen Connors, Tracy Joshi, Gheorghe Doros, Alexander Pogrebinsky, Andrea Havasi

summary/abstract:

Rationale & Objective: Test the feasibility of replacing 24-hour urine collection with a single voided urinary protein-creatinine ratio (UPCR) in patients with amyloid light-chain (AL) amyloidosis.
 
Study Design: Retrospective study examining the correlation between a 24-hour urine measurement and UPCR at various proteinuria levels using a linear regression analysis with Pearson’s correlation coefficient (r). We assessed how using these 2 different measurements would alter the diagnosis, staging, and kidney response assessment in patients with AL amyloidosis.
 
Results: The correlation between 24-hour urine and UPCR was moderate in patients with proteinuria levels of 500-3,000 mg/day and >3,000 mg/day, with r values of 0.57 and 0.62, respectively. Replacing the 24-hour urine collection with UPCR changed kidney staging in 10% of the patients: 77% were reclassified to a worse kidney stage and 23% to a more favorable stage. The majority of changes (85%) in kidney staging occurred in the >3,000 mg/day cohort. There were 35 patients whose kidney response was assessed by concomitant 24-hour urine collection and UPCR with visits at least 6 months apart. Of these patients, 20% had discordance between the 24-hour urine collection and UPCR that changed their definition of organ response.
 
Conclusions: Although the 24-hour urine collection is cumbersome, we continue to recommend it in patients with AL amyloidosis because replacing the 24-hour urine collection with UPCR would change kidney staging and organ response in 10%-20% of patients. In addition, the correlation between the 2 modalities was moderate at best in patients with nephrotic-range proteinuria.
 
organization: Boston University School of Medicine, USA; Boston University School of Public Health, USA; Boston Medical Center, USA

DOI: 10.1016/j.xkme.2022.100427

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