Microalbuminuria: do we need a new threshold?

Zamora, Carlos; Cubeddu, Luigi X.

doi:10.1038/jhh.2008.105

Cited by 17 publications

(14 citation statements)

References 35 publications

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“…These findings suggest that patients in whom daily urinary albumin excretion exceeds 24.5 mg/24 h might already be at risk of microangiopathy development. Our results are consistent with studies of other authors who have shown that there is a strong need to identify new lower thresholds for microalbuminuria [44].…”

Section: Discussionsupporting

confidence: 96%

Threshold serum concentrations of tumour necrosis factor alpha (TNFα) as a potential marker of the presence of microangiopathy in children and adolescents with type 1 diabetes mellitus (T1DM)

Zorena¹,

Kula²,

Malinowska³

et al. 2013

Human Immunology

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Section: Discussionsupporting

confidence: 96%

Threshold serum concentrations of tumour necrosis factor alpha (TNFα) as a potential marker of the presence of microangiopathy in children and adolescents with type 1 diabetes mellitus (T1DM)

Zorena¹,

Kula²,

Malinowska³

et al. 2013

Human Immunology

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“…The threshold values of UAE that are associated with increased risk have been reported to be substantially lower than the currently recommended level for MA [46]. Despite a lack of outcome studies, the available data suggest that these limits should be reduced by approximately three-fold, from 30 to 10 mg/g Cr for the UACR.…”

Section: Significance and Clinical Relevance Of This Studymentioning

confidence: 94%

Detection of Lower Albuminuria Levels and Early Development of Diabetic Kidney Disease Using an Artificial Intelligence-Based Rule Extraction Approach

Hayashi

2019

Diagnostics

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The aim of the present study was to determine the lowest cut-off value for albuminuria levels, which can be used to detect diabetic kidney disease (DKD) using the urinary albumin-to-creatinine ratio (UACR). National Health and Nutrition Examination Survey (NHANES) data for US adults were used, and participants were classified as having diabetes or prediabetes based on a self-report and physiological measures. The study dataset comprised 942 diabetes and 524 prediabetes samples. This study clarified the significance of the lower albuminuria (UACR) levels, which can detect DKD, using an artificial intelligence-based rule extraction approach. The diagnostic rules (15 concrete rules) for both samples were extracted using a recursive-rule eXtraction (Re-RX) algorithm with continuous attributes (continuous Re-RX) to discriminate between prediabetes and diabetes datasets. Continuous Re-RX showed high test accuracy (77.56%) and a large area under the receiver operating characteristics curve (75%), which derived the two cut-off values (6.1 mg/g Cr and 71.00 mg/g Cr) for the lower albuminuria level in the UACR to detect early development of DKD. The early cut-off values for normoalbuminuria (NA) and microalbuminuria (MA) will be determined to help detect CKD and DKD, and to detect diabetes before MA develop and to prevent diabetic complications.

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“…12,13 Macroalbuminuria was defined as ACR 425 mg mmol − 1 in both genders. 13 For those with increased urinary albumin excretion (UAE) according to the above thresholds, two further first morning void urine samples were obtained and reviewed.…”

Section: Mau and Macroalbuminuria Screeningmentioning

confidence: 99%

Microalbuminuria in subjects with hypertension attending specialist blood pressure clinics

et al. 2015

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Albuminuria is associated with increased risk of cardiovascular disease and target organ damage in patients with diabetes mellitus. In nondiabetic hypertensive patients, the threshold at which microalbuminuria (MAU) increases risk is unclear and there is evidence that cardiovascular risk may be increased in individuals with MAU levels lower than the usual recommended screening thresholds. We compared two definitions of MAU (on the basis of three early morning urine samples) in a cohort of hypertensive patients attending two specialist clinics in Scotland: conventional (MAU(C)) albumin-to-creatinine ratio (ACR) >2.5-25 mg mmol(-1) in males or >3.5-25 mg mmol(-1) in females; and low-grade (MAU(L)) ACR 1.2-2.5 in males or 1.7-3.5 mg mmol(-1) in females. Of the 1059 subjects screened, 786 (74%) were nondiabetic, with estimated glomerular filtration rate ⩾30 ml min(-1) per 1.73 m(2) and without gross proteinuria (low-risk subset). The average age was 58±15 years, body mass index 30±6 kg m(-2) and 46% were males. The prevalence of MAU(C) was 11% and 9.5% in the overall and low-risk subset, respectively, whereas MAU(L) prevalence was 11.1% and 10% respectively. The prevalence of cardiovascular disease was higher (24%) with albuminuria (both MAU(C) and MAU(L)) compared with 14% among those without albuminuria. The use of MAU(L) doubled the number of hypertensive subjects with increased cardiovascular risk who can be targeted for more rigorous risk reduction strategies. Consideration should be given to reducing the current threshold for MAU.

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Microalbuminuria: do we need a new threshold?

Cited by 17 publications

References 35 publications

Threshold serum concentrations of tumour necrosis factor alpha (TNFα) as a potential marker of the presence of microangiopathy in children and adolescents with type 1 diabetes mellitus (T1DM)

Threshold serum concentrations of tumour necrosis factor alpha (TNFα) as a potential marker of the presence of microangiopathy in children and adolescents with type 1 diabetes mellitus (T1DM)

Detection of Lower Albuminuria Levels and Early Development of Diabetic Kidney Disease Using an Artificial Intelligence-Based Rule Extraction Approach

Microalbuminuria in subjects with hypertension attending specialist blood pressure clinics

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