Microalbuminuria in pediatric patients with  hypertension

Varda, Nataša Marčun

doi:10.4236/health.2013.54a006

Cited by 3 publications

(3 citation statements)

References 66 publications

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“…There are limited studies on elevated urinary ACR and its reference value in healthy children. 15,16 In this study, we found the median urinary ACR as 10.5 (3-88) mg/g, Urinary ACR was measured among healthy children aged 1-35 months. A study in normal Korean children reported that urinary ACR decreased with age, with the mean values being 22.72 (SD=13.8) mg/mmol for the age group of 1-12 months and 16.34 (SD=9.58) mg/mmol for the age group of 13-28 months.…”

Section: Discussionmentioning

confidence: 55%

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Correlation between urinary albumin to creatinine ratio and systemic glycocalyx degradation in pediatric sepsis

et al. 2018

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Background: Increased capillary permeability in sepsis is associated with several complications and worse outcomes. Glycocalyx degradation, marked by increased serum syndecan-1 levels, alters vascular permeability, which can manifest as albuminuria in the glomerulus. Therefore, elevated urinary albumin to creatinine ratio (ACR) potentially provides an index of systemic glycocalyx degradation. The aim of this study was to analyze the correlation between urinary ACR and serum syndecan-1 levels.Methods: A longitudinal prospective study with repeated cross-sectional design was conducted on children with sepsis in pediatric intensive care unit, we evaluated serum syndecan-1 levels and urinary ACR on days 1, 2, 3, and 7. A descriptive study on healthy children was also conducted to determine the reference value of syndecan-1 in children.Results: 49 subjects with sepsis were recruited. Based on the data of the healthy children group (n=30), syndecan-1 level of >90th percentile (41.42 ng/mL) was defined as systemic glycocalyx degradation. The correlation coefficients (r) between urinary ACR and syndecan-1 levels were 0.32 (p<0.001) from all examination days (162 specimens), 0.298 (p=0.038) on day 1, and 0.469 (p=0.002) on day 3. The area under the curve of urinary ACR and systemic glycocalyx degradation was 65.7% (95% CI 54.5%–77%; p=0.012). Urinary ACR ≥157.5 mg/g was determined as the cut-off point for glycocalyx degradation, with a sensitivity of 77.4% and a specificity of 48%.Conclusion: Urinary ACR showed a weak correlation with systemic glycocalyx degradation, indicating that the pathophysiology of elevated urinary ACR in sepsis is not merely related to glycocalyx degradation.

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Section: Discussionmentioning

confidence: 55%

“…This value was similar to that reported by Hurtado et al which demonstrated that elevated urinary ACR can be found in healthy subjects. 17 Pediatric population is an ideal group for studying urinary ACR because of the relatively minimal multiple morbidities that are commonly found in adults, 16 such as diabetes and hypertension.…”

Section: Discussionmentioning

confidence: 99%

Correlation between urinary albumin to creatinine ratio and systemic glycocalyx degradation in pediatric sepsis

et al. 2018

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“…Microalbuminuria defined by abnormal or supranormal urinary excretion of albumin is a well-known independent predictor of CVD morbidity and mortality [ 37 ]. Although there have been large population-based studies on the prevalence of microalbuminuria in adults, there have been fewer studies in children.…”

Section: Discussionmentioning

confidence: 99%

Relationship between High Blood Pressure and Microalbuminuria in Children Aged 6–9 Years in a South African Population

et al. 2020

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Though the association between high blood pressure and microalbuminuria is well established in adults, there is a paucity of information on microalbuminuria in children. This study investigated the relationship between high blood pressure and microalbuminuria in 6–9-year-old children. A cross-sectional study, which included 306 primary school children of age 6–9 years old from urban areas (n = 154) and rural areas (n = 152) of the Eastern Cape Province of South Africa, was conducted. Participants’ anthropometric data were determined and systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured and converted to BP percentiles for age, sex and height. Creatinine and albumin concentrations were assayed in early morning midstream urine and the albumin to creatinine ratio (ACR) was calculated. There was a 42.8% prevalence of elevated blood pressure/high blood pressure (E-BP/H-BP) and a 10.1% prevalence of microalbuminuria. Among the 131 children with E-BP/H-BP, 17 had elevated ACR with a prevalence of 13.95%. SBP and HR increased with increasing range of ACR and, furthermore, SBP was significantly (p < 0.05) higher in children with moderately and severely increased ACR. SBP was associated with ACR and increased SBP predicted microalbuminuria (R2 = 0.42, adj R2 = 0.039, B: 0.120, p = < 0.05). In conclusion, microalbuminuria was present in 6–9-year-old South African children of African Ancestry and a weak association was observed with SBP in children.

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NGAL and cystatin C: two possible early markers of diabetic nephropathy in young patients with type 1 diabetes mellitus: one year follow up

Papadopoulou-Marketou¹,

Skevaki²,

Kosteria³

et al. 2014

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OBJECTIVE: Diabetic nephropathy constitutes a major long-term complication in patients with type 1 diabetes mellitus (T1D) and its diagnosis is based on microalbuminuria. The aim of this observational follow-up study was to explore the role of neutrophil-gelatinase-associated lipocalin (NGAL) and cystatin C in unravelling early diabetic nephropathy even in patients with normoalbuminuria. DESIGN: Fifty-six euthyroid patients with T1D, with mean age 13.1 (SD: 3.2) years, and 49 healthy controls with mean age 12.8 (SD: 6.6) were recruited. Besides standard blood chemistry and urinary albumin excretion, serum NGAL (ELISA) and cystatin C (nephelometry) were measured at enrollment and after 12-15 months. GFR was calculated with the bedside Schwartz formula (eGFR) and the Lund strategy formula (L-eGFR). RESULTS: At baseline, mean NGAL levels were not significantly different between children with diabetes and controls. At re-evaluation, mean NGAL value and mean eGFR value in patients with diabetes were increased (p=0.032 and p=0.003 respectively). At both baseline and reevaluation, NGAL was positively correlated with cystatin C (r=0.41, p<0.001), systolic arterial pressure z-score (r=0.3, p=0.031) and creatinine (r=0.32, p=0.010). NGAL correlated negatively with eGFR (r=-0.26, p=0.049) and L-eGFR (r=-0.33, p=0.010). Cystatin C had a negative correlation to eGFR (r=-0.29, p=0.025) and a positive one with creatinine (r=0.35, p=0.009) at reevaluation. No statistically significant correlation was found between cystatin C and microalbuminuria (p=0.736). CONCLUSIONS: NGAL and cystatin C, known markers of renal injury, correlate with renal function decline in T1D, suggesting that they may be used as supplementary tests to urine albumin excretion in order to unmask early renal dysfunction.

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Microalbuminuria in pediatric patients with hypertension

Cited by 3 publications

References 66 publications

Correlation between urinary albumin to creatinine ratio and systemic glycocalyx degradation in pediatric sepsis

Correlation between urinary albumin to creatinine ratio and systemic glycocalyx degradation in pediatric sepsis

Relationship between High Blood Pressure and Microalbuminuria in Children Aged 6–9 Years in a South African Population

NGAL and cystatin C: two possible early markers of diabetic nephropathy in young patients with type 1 diabetes mellitus: one year follow up

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