Dataset Information
Correlation Between 24-Hour Urine Protein and Random Urine Protein-Creatinine Ratio in Amyloid Light-Chain Amyloidosis.
Ontology highlight
ABSTRACT: Rationale & objective
Test the feasibility of replacing 24-hour urine collection with a single voided urinary protein-creatinine ratio (UPCR) in patients with amyloid light-chain (AL) amyloidosis.Study design
Retrospective study examining the correlation between a 24-hour urine measurement and UPCR at various proteinuria levels using a linear regression analysis with Pearson's correlation coefficient (r). We assessed how using these 2 different measurements would alter the diagnosis, staging, and kidney response assessment in patients with AL amyloidosis.Setting & participants
We included 265 patients with systemic AL amyloidosis who visited the Amyloidosis Center at Boston University between July 2018-January 2020 and had proteinuria measurement by both methods on the same day.Tests compared
24-hour urine collection for protein versus UPCR.Results
The correlation between 24-hour urine and UPCR was moderate in patients with proteinuria levels of 500-3,000 mg/day and >3,000 mg/day, with r values of 0.57 and 0.62, respectively. Replacing the 24-hour urine collection with UPCR changed kidney staging in 10% of the patients: 77% were reclassified to a worse kidney stage and 23% to a more favorable stage. The majority of changes (85%) in kidney staging occurred in the >3,000 mg/day cohort. There were 35 patients whose kidney response was assessed by concomitant 24-hour urine collection and UPCR with visits at least 6 months apart. Of these patients, 20% had discordance between the 24-hour urine collection and UPCR that changed their definition of organ response.Limitations
Given the rarity of AL amyloidosis, our sample size is small and from a single referral center.Conclusions
Although the 24-hour urine collection is cumbersome, we continue to recommend it in patients with AL amyloidosis because replacing the 24-hour urine collection with UPCR would change kidney staging and organ response in 10%-20% of patients. In addition, the correlation between the 2 modalities was moderate at best in patients with nephrotic-range proteinuria.
SUBMITTER: Mendelson L
PROVIDER: S-EPMC8942830 | biostudies-literature | 2022 Apr
REPOSITORIES: biostudies-literature
Publications
Correlation Between 24-Hour Urine Protein and Random Urine Protein-Creatinine Ratio in Amyloid Light-Chain Amyloidosis.
Kidney medicine 20220203 4
<h4>Rationale & objective</h4>Test the feasibility of replacing 24-hour urine collection with a single voided urinary protein-creatinine ratio (UPCR) in patients with amyloid light-chain (AL) amyloidosis.<h4>Study design</h4>Retrospective study examining the correlation between a 24-hour urine measurement and UPCR at various proteinuria levels using a linear regression analysis with Pearson's correlation coefficient (r). We assessed how using these 2 different measurements would alter the diagno ...[more]