Relationship between urinary microalbumin creatinine ratio and diabetic retinopathy in type 2 diabetic patients in Hefei area / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the correlation between urinary microalbumin creatinine ratio and diabetic retinopathy(DR)in type 2 diabetic patients in Hefei area. <p>METHODS: A retrospective case analysis. 281 patients with type 2 diabetes mellitus(T2DM)hospitalized in Hefei Second People's Hospital from November 2018 to September 2019 were conducted in this study. According to the digital fundus photography, the patients were divided into diabetic retinopathy group(DR group)and non-diabetic retinopathy group(NDR group). The patients' gender, age, course of diabetes, history of hypertension, body mass index(BMI), blood urea nitrogen(BNU), urinary microalbumin creatinine ratio(UACR),fasting blood glucose, HbA1c, total bilirubin(TB), total cholesterol(TC), triglyceride(TG)were collected and risk factors of DR were analyzed.<p>RESULTS: A total of 281 cases, 169(60.1%)were in the NDR group and 112(39.9%)in the DR group. Logistic regression analysis and ROC curve analysis showed that the risk factors related to DR were UACR(β=0.036,<i> OR</i>=1.037, 95% <i>CI</i>:<i> </i>1.019-1.056, <i>P</i><0.001), the best critical value was 10.15mg/g·Cr(AUC=0.717, <i>P</i><0.001); the course of diabetes(β=0.061, <i>OR</i>=1.063, 95% <i>CI</i>: 1.008-1.120, <i>P</i>=0.023), the best critical value was 10.5a(AUC=0.666, <i>P</i><0.001).<p>CONCLUSION: UACR and the course of diabetes are independent risk factors for DR in some of the patients with type 2 diabetes in Hefei.

Association between the serum CysC,lipoprotein(a) and urinary microalbumin/creatinine ratio among elderly type 2 dibetic patients / 国际检验医学杂志

Objective To analyze the relationship between the serum CysC,lipoprotein(a) [Lp(a)] and the urinary microalbumin/creatinine ratio in elderly type 2 dibetic (T2CM) patients.Methods A total of 102 elderly patients with T2CM who were treated in our hospital from December 2014 to December 2015 were selected.The patients were divided into diabetic nephropathy(DN) group(mALB≥20 μg/min,48 cases)and non-diabetic nephropathy(NDN) group (mALB<20 μg/min,54 cases) according the levels of urinary mALB,while 30 cases of healthy controls were selected from physical examination center.The biochemical indexes,CysC,Lp(a) and UACR were detected among all cases.The correlation between indexes and UACR was analyzed by Pearson correlation analysis,risk factors for UACR among DN patients were analyzed by Logistic regression analysis.Results There were significant differences in levels of low density lipoprotein cholesterol(LDL-C),Lp(a),urea,creatinine,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),Cysc,and UACR among these groups (P<0.05).No correlation between CysC、Lp(a) and UACR was found in normal-control group and non-diabetic nephropathy group.In diabetic nephropathy group,there was a positive correlation between CysC,Lp(a) and UACR(r=0.658,P<0.01;r=0.525,P<0.05).The Logistic regression analysis showed that diabetes duration,CysC,Lp(a) were independent risk factors for UACR(P<0.05).Conclusion In patients with diabetic nephropathy,CysC,Lp(a) are positively correlated with UACR,and CysC is a sensitive index that reflect early renal damage in T2DM patients.Lp(a) level is one of the independent risk factors for UACR,which can reveal the kidney damage in DN patients.

Microalbuminuria en pacientes pediátricos con diagnóstico de síndrome hemolítico urémico / Microalbuminuria in pediatric patients diagnosed with hemolytic uremic syndrome

Introducción: El síndrome hemolítico urémico (SHU) se caracteriza por la presencia de anemia hemolítica microangiopática, trombocitopenia y afectación renal aguda. Es la principal causa de falla renal aguda en niños menores de 3 años. Un número variable de pacientes evoluciona con afectación renal a largo plazo con proteinuria, hipertensión arterial e insuficiencia renal crónica. Objetivo: Evaluar la afectación renal mediante el índice microalbuminuria/creatininuria en pacientes pediátricos con diagnóstico de SHU. Pacientes y Método: Estudio descriptivo de cohorte concurrente que analizó la presencia de microalbuminuria en pacientes diagnosticados de SHU entre enero de 2001 y marzo de 2012, que evolucionaron sin hipertensión y con función renal normal (clearance mayor de 90 ml/min medido por fórmula de Schwartz). Se evaluaron factores demográficos (edad, sexo), presentación clínica en el momento del diagnóstico, uso de antibióticos previo al ingreso y requerimiento de terapia de reemplazo renal. Resultados: Se estudiaron 24 pacientes, el 54% varones; la edad promedio en el momento del diagnóstico fue de 2 años; un 45% requirió diálisis peritoneal; un 33% evolucionó con microalbuminuria persistente; cuatro pacientes recibieron tratamiento antiproteinúrico con buena respuesta. El promedio de seguimiento fue de 6 años (rango: 6 meses a 11 años); todos los pacientes durante el seguimiento evolucionaron con creatinina plasmática normal. Conclusiones: En nuestro grupo, el porcentaje de microalbuminuria persistente en pacientes con diagnóstico previo de SHU fue similiar a lo descrito en la literatura; el tratamiento con antiproteinúricos podría retrasar el daño renal, pero es necesario realizar estudios prospectivos multicéntricos.

Introduction: Hemolytic uremic syndrome (HUS) is characterized by the presence of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney failure. It is the leading cause of acute kidney failure in children under 3 years of age. A variable number of patients develop proteinuria, hypertension, and chronic renal failure. Objective: To evaluate the renal involvement in pediatric patients diagnosed with HUS using the microalbumin/creatinine ratio. Patients and Methods: Descriptive concurrent cohort study that analyzed the presence of microalbuminuria in patients diagnosed with HUS between January 2001 and March 2012, who evolved without hypertension and normal renal function (clearance greater than 90 ml/min using Schwartz formula). Demographic factors (age, sex), clinical presentation at time of diagnosis, use of antibiotics prior to admission, and need for renal replacement therapy were evaluated. Results: Of the 24 patients studied, 54% were male. The mean age at diagnosis was two years. Peritoneal dialysis was required in 45%, and 33% developed persistent microalbuminuria. Antiproteinuric treatment was introduce in 4 patients, with good response. The mean follow-up was 6 years (range 6 months to 11 years). The serum creatinine returned to normal in all patients during follow up. Conclusions: The percentage of persistent microalbuminuria found in patients with a previous diagnosis of HUS was similar in our group to that described in the literature. Antiproteinuric treatment could delay kidney damage, but further multicenter prospective studies are necessary.

The Change of Urinary Microalbumin During Pregnancy / 대한진단검사의학회지

BACKGROUND: Preeclampsia is a frequent cause of maternal or fetal morbidity and mortality. There have been many trials to use microalbuminuria as a predictor for preeclampsia, but the usefulness is controversial. Authors have studied the changes in urinary microalbumin excretion during normal pregnancy to help establish a reference interval in which physiologic alteration during pregnancy is reflected. METHODS: During the period from January to April 1999 and from December 1999 to January 2000, urinary albumin and creatinine levels were measured in the 151 spot urine samples from pregnant women visiting Hanyang University Kuri Hospital for prenatal care. They were free of hypertension, proteinuria, and renal diseases at the time of sampling for the medical records. A homemade ELISA and the Cobas Integra 700 were used to measure the urinary albumin and urinary creatinine levels. The analysis of the data was performed as urinary microalbumin/creatinine ratio (ACR). RESULTS: In the 146 urine samples from normotensive pregnant women, urine ACR was 1.36+/-1.72 g/mol (mean+/-standard deviation). The urine ACR was 0.83+/-1.12 g/mol in the first trimester, 1.06+/-1.38 g/mol in the second trimester, and 1.82+/-1.06 g/mol in the third trimester. The urine ACR of the third trimester was significantly different from that of the first or second trimester (3rd vs 1st, P=0.026 and 3rd vs 2nd, P=0.011). CONCLUSIONS: During the course of normal pregnancy, urinary microalbumin excretions increased significantly in the third trimester. It is necessary that the reference interval for urinary microalbumin excretions be established based on gestational weeks.