We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Urine alpha 1-microglobulin-to-creatinine ratio and beta 2-microglobulin-to-creatinine ratio for detecting CAKUT with kidney dysfunction in children.
- Authors
Hamada, Riku; Kikunaga, Kaori; Kaneko, Tetsuji; Okamoto, Shojiro; Tomotsune, Masako; Uemura, Osamu; Kamei, Koichi; Wada, Naohiro; Matsuyama, Takeshi; Ishikura, Kenji; Oka, Akira; Honda, Masataka
- Abstract
Background: The leading cause of advanced chronic kidney disease (CKD) in children is congenital anomalies of the kidney and urinary tract (CAKUT). However, the most appropriate parameters of biochemical urine analysis for detecting CAKUT with kidney dysfunction are not known. Methods: The present observational study analyzed data on children with CAKUT (stage 2–4 CKD) and the general pediatric population obtained from school urine screenings. The sensitivity and specificity of urine alpha 1-microglobulin-, beta 2-microglobulin-, protein-, and the albumin-to-creatinine ratios (AMCR, BMCR, PCR, ACR, respectively) in detecting CAKUT with kidney dysfunction were compared with those of the conventional urine dipstick, and the most appropriate of these four parameters were evaluated. Results: In total, 77 children with CAKUT and 1712 subjects in the general pediatric population fulfilled the eligibility criteria. Conventional dipstick urinalysis was insufficient due to its low sensitivity; even when the threshold of proteinuria was +/−, its sensitivity was only 29.7% for stage 2 and 44.1% for stage 3 CKD. Among the four parameters assessed, the AMCR and BMCR were adequate for detecting CAKUT in children with stage 3–4 CKD (the respective sensitivity and specificity of the AMCR for detecting CAKUT in stage 3 CKD was 79.4% and 97.5% while that of BMCR was 82.4% and 97.5%). These data were validated using national cohort data. Conclusion: AMCR and BMCR are superior to dipstick urinalysis, PCR, and ACR in detecting CAKUT with kidney dysfunction, particularly stage 3 CKD. However, for AMCR, external validation is required. A higher resolution version of the Graphical abstract is available as Supplementary information
- Subjects
KIDNEY disease diagnosis; KIDNEY abnormalities; URINARY organ abnormalities; CHRONIC kidney failure; BLOOD proteins; SCIENTIFIC observation; MEDICAL screening; PROTEINURIA; DESCRIPTIVE statistics; GLOBULINS; SENSITIVITY &; specificity (Statistics); URINALYSIS; CREATININE; DISEASE risk factors; CHILDREN
- Publication
Pediatric Nephrology, 2023, Vol 38, Issue 2, p479
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-022-05577-3