Age- and Gender-Specific Diagnostic Value of the Albumin-to-Creatinine Ratio for the Early Screening of Chronic Kidney Disease Among Middle-Aged and Elderly Males in Southeast China

OBJECTIVE: To evaluate the potential diagnostic value of the albumin-to-creatinine ratio (ACR) in screening for early kidney injury in a physically examined population from Southeast China. METHODS: A total of 13,250 candidates were selected. Urinary ACR values <30, 30–300, and >300 mg/g were utilized as positive cut-off points to denote normal proteinuria, microalbuminuria, and macroalbuminuria, respectively. RESULTS: Age, systolic blood pressure, diastolic blood pressure, body mass index, waistline, fasting blood glucose, glycated hemoglobin, triglycerides, and high-density lipoprotein cholesterol were significantly different among the three groups. eGFR was negatively correlated with the levels of sCr, BUN, and UA in the microalbuminuria and macroalbuminuria groups. Furthermore, there was a significant difference in CKD stage between the normal and abnormal urine ACR groups. Meanwhile, for the 20–40 years patients, the eGFR, sCr and BUN showed no significant difference between microalbuminuria group compared with the normal proteinuria group; in contrast, for the 41–60 years and >61 years patients, eGFR, sCr, BUN and UA were all markedly increase in microalbuminuria and macroalbuminuria group in comparison with the normal proteinuria group. Finally, for the 41–60 males, only eGFR significantly decreased in microalbuminuria group compared with the normal proteinuria group, while for the 41–60 females, only UA showed no significant difference between microalbuminuria group and normal proteinuria group. On the other hand, for the >61 males, eGFR, sCr and BUN all significantly changed between microalbuminuria group and normal proteinuria group, while for the >61 females, eGFR, sCr and BUN all showed no significant difference between microalbuminuria group and normal proteinuria group, as well as microalbuminuria group and macroalbuminuria group. CONCLUSION: We proposed using the urinary ACR for the screening of physically examined patients, especially among the elderly males. This approach would assist in the early diagnosis and treatment of renal damage.