Current Issues in Measurement and Reporting of Urinary Albumin Excretion
Open Access
- 1 January 2009
- journal article
- review article
- Published by Oxford University Press (OUP) in Clinical Chemistry
- Vol. 55 (1), 24-38
- https://doi.org/10.1373/clinchem.2008.106567
Abstract
Background: Urinary excretion of albumin indicates kidney damage and is recognized as a risk factor for progression of kidney disease and cardiovascular disease. The role of urinary albumin measurements has focused attention on the clinical need for accurate and clearly reported results. The National Kidney Disease Education Program and the IFCC convened a conference to assess the current state of preanalytical, analytical, and postanalytical issues affecting urine albumin measurements and to identify areas needing improvement. Content: The chemistry of albumin in urine is incompletely understood. Current guidelines recommend the use of the albumin/creatinine ratio (ACR) as a surrogate for the error-prone collection of timed urine samples. Although ACR results are affected by patient preparation and time of day of sample collection, neither is standardized. Considerable intermethod differences have been reported for both albumin and creatinine measurement, but trueness is unknown because there are no reference measurement procedures for albumin and no reference materials for either analyte in urine. The recommended reference intervals for the ACR do not take into account the large intergroup differences in creatinine excretion (e.g., related to differences in age, sex, and ethnicity) nor the continuous increase in risk related to albumin excretion. Discussion: Clinical needs have been identified for standardization of (a) urine collection methods, (b) urine albumin and creatinine measurements based on a complete reference system, (c) reporting of test results, and (d) reference intervals for the ACR.Keywords
This publication has 92 references indexed in Scilit:
- Physiological and pathological changes in the redox state of human serum albumin critically influence its binding propertiesBritish Journal of Pharmacology, 2007
- Urine Biomarkers Predict the Cause of Glomerular DiseaseJournal of the American Society of Nephrology, 2007
- Performance Characteristics of an HPLC Assay for Urinary AlbuminAmerican Journal of Clinical Pathology, 2005
- Management of hypertension and screening of renal complications by GPs in diabetic type 2 patients (France — 2001)Diabetes & Metabolism, 2003
- Molecular characteristics of methylglyoxal-modified bovine and human serum albumins. Comparison with glucose-derived advanced glycation endproduct-modified serum albuminsJournal of Protein Chemistry, 1995
- Isolated proteinuria: Analysis of a school-age populationThe Journal of Pediatrics, 1982
- Prognosis in Postural (Orthostatic) ProteinuriaThe New England Journal of Medicine, 1981
- Molecular Basis of Proteinuria of Glomerular OriginThe New England Journal of Medicine, 1978
- Proteinuria and hematuria in schoolchildren: Epidemiology and early natural historyThe Journal of Pediatrics, 1976
- Epidemiology of proteinuria: A study of 4,807 schoolchildrenThe Journal of Pediatrics, 1968