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An equation to estimate 24-hour total urine protein excretion rate in patients who underwent urine protein testing

BACKGROUND: The urine protein-creatinine ratio (UPCR) in a spot first-morning urine sample is used to estimate 24-h urine proteinuria (24hUP) in patients who underwent urine protein testing. UPCR cannot be directly compared with 24-h proteinuria. Thus, an equation to estimate 24-h total protein excr...

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Autores principales: Yang, Fan, Shi, Jing-Song, Gong, Si-Wen, Xu, Xiao-Dong, Le, Wei-Bo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801121/
https://www.ncbi.nlm.nih.gov/pubmed/35093023
http://dx.doi.org/10.1186/s12882-022-02673-2
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author Yang, Fan
Shi, Jing-Song
Gong, Si-Wen
Xu, Xiao-Dong
Le, Wei-Bo
author_facet Yang, Fan
Shi, Jing-Song
Gong, Si-Wen
Xu, Xiao-Dong
Le, Wei-Bo
author_sort Yang, Fan
collection PubMed
description BACKGROUND: The urine protein-creatinine ratio (UPCR) in a spot first-morning urine sample is used to estimate 24-h urine proteinuria (24hUP) in patients who underwent urine protein testing. UPCR cannot be directly compared with 24-h proteinuria. Thus, an equation to estimate 24-h total protein excretion rate, using age, gender, and the UPCR may improve its bias and accuracy in patients who underwent urine protein testing. METHODS: We simultaneously measured 24-h urine protein and the same day’s first-morning spot urine from patients with kidney disease. Generalized linear and no-linear models, using age, gender, and UPCR, were constructed to estimate for 24-h urine protein and the best model (NJ equation) was selected to estimated 24 hUP (e24hUP). RESULTS: A total of 5435 paired samples (including a training cohort of 3803 patients and a validation cohort of 1632 patients) were simultaneously measured for UPCR and 24-h urine protein. In the training cohort, the unadjusted UPCR obviously underestimated 24-h urine protein when UPCR ≤1.2 g/g (median bias − 0.17 g/24 h) and overestimated 24-h urine protein when UPCR > 1.2 g/g (median bias 0.53 g/24 h). In the validation cohort, the NJ equation performed better than the unadjusted UPCR, with lower root mean square error (0.81 vs. 1.02, P < 0.001), less bias (median difference between measured and estimated urine protein, − 0.008 vs. 0.12), improved precision (interquartile range of the differences, 0.34 vs. 0.50), and greater accuracy (percentage of estimated urine protein within 30% of measured urine protein, 53.4% vs. 32.2%). Bland-Altman plot indicated that the agreement of spot and daily estimates was less pronounced with 24 hUP > 2 g than lower values. CONCLUSIONS: The NJ e24hUP equation is more accurate than unadjusted UPCR to estimate 24 hUP in patients with kidney disease and could be used for laboratory application. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12882-022-02673-2.
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spelling pubmed-88011212022-02-02 An equation to estimate 24-hour total urine protein excretion rate in patients who underwent urine protein testing Yang, Fan Shi, Jing-Song Gong, Si-Wen Xu, Xiao-Dong Le, Wei-Bo BMC Nephrol Research BACKGROUND: The urine protein-creatinine ratio (UPCR) in a spot first-morning urine sample is used to estimate 24-h urine proteinuria (24hUP) in patients who underwent urine protein testing. UPCR cannot be directly compared with 24-h proteinuria. Thus, an equation to estimate 24-h total protein excretion rate, using age, gender, and the UPCR may improve its bias and accuracy in patients who underwent urine protein testing. METHODS: We simultaneously measured 24-h urine protein and the same day’s first-morning spot urine from patients with kidney disease. Generalized linear and no-linear models, using age, gender, and UPCR, were constructed to estimate for 24-h urine protein and the best model (NJ equation) was selected to estimated 24 hUP (e24hUP). RESULTS: A total of 5435 paired samples (including a training cohort of 3803 patients and a validation cohort of 1632 patients) were simultaneously measured for UPCR and 24-h urine protein. In the training cohort, the unadjusted UPCR obviously underestimated 24-h urine protein when UPCR ≤1.2 g/g (median bias − 0.17 g/24 h) and overestimated 24-h urine protein when UPCR > 1.2 g/g (median bias 0.53 g/24 h). In the validation cohort, the NJ equation performed better than the unadjusted UPCR, with lower root mean square error (0.81 vs. 1.02, P < 0.001), less bias (median difference between measured and estimated urine protein, − 0.008 vs. 0.12), improved precision (interquartile range of the differences, 0.34 vs. 0.50), and greater accuracy (percentage of estimated urine protein within 30% of measured urine protein, 53.4% vs. 32.2%). Bland-Altman plot indicated that the agreement of spot and daily estimates was less pronounced with 24 hUP > 2 g than lower values. CONCLUSIONS: The NJ e24hUP equation is more accurate than unadjusted UPCR to estimate 24 hUP in patients with kidney disease and could be used for laboratory application. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12882-022-02673-2. BioMed Central 2022-01-29 /pmc/articles/PMC8801121/ /pubmed/35093023 http://dx.doi.org/10.1186/s12882-022-02673-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Yang, Fan
Shi, Jing-Song
Gong, Si-Wen
Xu, Xiao-Dong
Le, Wei-Bo
An equation to estimate 24-hour total urine protein excretion rate in patients who underwent urine protein testing
title An equation to estimate 24-hour total urine protein excretion rate in patients who underwent urine protein testing
title_full An equation to estimate 24-hour total urine protein excretion rate in patients who underwent urine protein testing
title_fullStr An equation to estimate 24-hour total urine protein excretion rate in patients who underwent urine protein testing
title_full_unstemmed An equation to estimate 24-hour total urine protein excretion rate in patients who underwent urine protein testing
title_short An equation to estimate 24-hour total urine protein excretion rate in patients who underwent urine protein testing
title_sort equation to estimate 24-hour total urine protein excretion rate in patients who underwent urine protein testing
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801121/
https://www.ncbi.nlm.nih.gov/pubmed/35093023
http://dx.doi.org/10.1186/s12882-022-02673-2
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