Childhood Kidney Diseases

  • 제26권2호
  • /
  • Pages.69-73
  • /
  • 2022
  • /
  • 2384-0242(pISSN)
  • /
  • 2384-0250(eISSN)
대한소아신장학회 (Korean Society of Pediatric Nephrology)
권호 표지
DOI QR코드

DOI QR Code

Measurement of urinary protein in children

  • Myung Hyun, Cho (Department of Pediatrics, Hallym University Sacred Heart Hospital)
  • 투고 : 2022.05.04
  • 심사 : 2022.10.07
  • 발행 : 2022.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Proteinuria is an early hallmark of kidney disease and a major risk factor for systemic cardiovascular diseases. There are several methods to measure proteinuria, such as the urine dipstick test, 24-hour urinary protein excretion method, and spot urine for the protein-to-creatinine ratio. The urine dipstick test is simple but inaccurate. The 24-hour urinary protein excretion method is the gold standard; however, it is cumbersome, especially in children. Spot urine for the protein-to-creatinine ratio is simple and accurate, but has limitations. Specific urinary protein such as albumin can be measured instead of the total protein content. Tests should be avoided in situations that cause transient proteinuria or false-positive results. It should be performed correctly, and its limitations should be recognized and interpreted accurately.

키워드

참고문헌

  1. Currie G, Delles C. Proteinuria and its relation to cardiovascular disease. Int J Nephrol Renovasc Dis 2013;7:13-24. https://doi.org/10.2147/IJNRD.S40522
  2. White SL, Yu R, Craig JC, Polkinghorne KR, Atkins RC, Chadban SJ. Diagnostic accuracy of urine dipsticks for detection of albuminuria in the general community. Am J Kidney Dis 2011;58:19-28. https://doi.org/10.1053/j.ajkd.2010.12.026
  3. Ariceta G. Clinical practice: proteinuria. Eur J Pediatr 2011;170:15-20. https://doi.org/10.1007/s00431-010-1334-0
  4. Aukland K, Lygren T. Albustix for testing proteinuria a comparison with Heller's test judged by quantitative determination of protein. Scand J Clin Lab Invest 1959;11:172-6. https://doi.org/10.3109/00365515909060429
  5. Lamb EJ, MacKenzie F, Stevens PE. How should proteinuria be detected and measured? Ann Clin Biochem 2009;46(Pt 3):205-17. https://doi.org/10.1258/acb.2009.009007
  6. Larkins NG, Teixeira-Pinto A,Craig JC. A narrative review of proteinuria and albuminuria as clinical biomarkers in children. J Paediatr Child Health 2019;55:136-42.
  7. Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, et al. Nelson textbook of pediatrics. 2nd ed. Philadelphia: Elsevier; 2020.
  8. Simerville JA, Maxted WC, Pahira JJ. Urinalysis: a comprehensive review. Am Fam Physician 2005;71:1153-62.
  9. Utsch B, Klaus G. Urinalysis in children and adolescents. Dtsch Arztebl Int 2014;111:617-26.
  10. Filler G, Huang SS. Spot urine protein to creatinine ratio. Pediatr Nephrol 2017;32:917-9. https://doi.org/10.1007/s00467-017-3605-8
  11. Kaminska J, Dymicka-Piekarska V, Tomaszewska J, Matowicka-Karna J, Koper-Lenkiewicz OM. Diagnostic utility of protein to creatinine ratio (P/C ratio) in spot urine sample within routine clinical practice. Crit Rev Clin Lab Sci 2020;57:345-64. https://doi.org/10.1080/10408363.2020.1723487
  12. Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int 2021;100(4S):S1-276. https://doi.org/10.1016/j.kint.2021.05.021
  13. Ginsberg JM, Chang BS, Matarese RA, Garella S. Use of single voided urine samples to estimate quantitative proteinuria. N Engl J Med 1983;309:1543-6. https://doi.org/10.1056/NEJM198312223092503
  14. Jang KM, Cho MH. Clinical approach to children with proteinuria. Child Kidney Dis 2017;21:53-60. https://doi.org/10.3339/jkspn.2017.21.2.53
  15. Abitbol C, Zilleruelo G, Freundlich M, Strauss J. Quantitation of proteinuria with urinary protein/creatinine ratios and random testing with dipsticks in nephrotic children. J Pediatr 1990;116:243-7. https://doi.org/10.1016/s0022-3476(05)82881-1
  16. Huang Y, Yang X, Zhang Y, Yue S, Mei X, Bi L, et al. Correlation of urine protein/creatinine ratios to 24-h urinary protein for quantitating proteinuria in children. Pediatr Nephrol 2020;35:463-8. https://doi.org/10.1007/s00467-019-04405-5
  17. Yang CY, Chen FA, Chen CF, Liu WS, Shih CJ, Ou SM, et al. Diagnostic accuracy of urine protein/creatinine ratio is influenced by urine concentration. PLoS One 2015;10:e0137460.
  18. Viswanathan G, Upadhyay A. Assessment of proteinuria. Adv Chronic Kidney Dis 2011;18:243-8. https://doi.org/10.1053/j.ackd.2011.03.002
  19. Yaribeygi H, Atkin SL, Katsiki N, Sahebkar A. Narrative review of the effects of antidiabetic drugs on albuminuria. J Cell Physiol 2019;234:5786-97.
  20. Castrop H, Schiessl IM. Novel routes of albumin passage across the glomerular filtrationbarrier.ActaPhysiol(Oxf) 2017;219:544-53.
  21. Stephen R, Jolly SE, Nally JV Jr, Navaneethan SD. Albuminuria: when urine predicts kidney and cardiovascular disease. Cleve Clin J Med 2014;81:41-50. https://doi.org/10.3949/ccjm.81a.13040
  22. National Institute for Health and Care Excellence (NICE). Chronic kidney disease: assessment and management [Internet]. London: NICE; c2021 [cited 2022 Sep 29]. Available from: https://www.nice.org.uk/guidance/ng203.
  23. Levin A, Stevens PE, Bilous RW, Coresh J, De Francisco AL, De Jong PE, et al. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl [Internet]. 2013 [cited 2022 Sep 29];3:1-150. Available from: https://jhu.pure.elsevier.com/en/publications/kidney-disease-improving-global-outcomes-kdigo-ckd-work-group-kdi-4.
  24. van den Belt SM, Gracchi V, de Zeeuw D, Heerspink HJ. How to measure and monitor albuminuria in healthy toddlers? PLoS One 2018;13:e0199309.
  25. Chae HW, Shin JI, Kwon AR, Kim HS, Kim DH. Spot urine albumin to creatinine ratio and serum cystatin C are effective for detection of diabetic nephropathy in childhood diabetic patients. J Korean Med Sci 2012;27:784-7. https://doi.org/10.3346/jkms.2012.27.7.784
  26. Tsioufis C, Mazaraki A, Dimitriadis K, Stefanidis CJ, Stefanadis C. Microalbuminuria in the paediatric age: current knowledge and emerging questions. Acta Paediatr 2011;100:1180-4. https://doi.org/10.1111/j.1651-2227.2011.02291.x
  27. Chiang JL, Maahs DM, Garvey KC, Hood KK, Laffel LM, Weinzimer SA, et al. Type 1 diabetes in children and adolescents: a position statement by the American Diabetes Association. Diabetes Care 2018;41:2026-44.
  28. Kashtan CE, Gross O. Clinical practice recommendations for the diagnosis and management of Alport syndrome in children, adolescents, and young adults: an update for 2020. Pediatr Nephrol 2021;36:711-9.
  29. Gimpel C, Bergmann C, Bockenhauer D, Breysem L, Cadnapaphornchai MA, Cetiner M, et al. International consensus statement on the diagnosis and management of autosomal dominant polycystic kidney disease in children and young people. Nat Rev Nephrol 2019;15:713-26.
  30. Fuhrman DY, Schneider MF, Dell KM, Blydt-Hansen TD, Mak R, Saland JM, et al. Albuminuria, proteinuria, and renal disease progression in children with CKD. Clin J Am Soc Nephrol 2017;12:912-20. https://doi.org/10.2215/cjn.11971116
  31. Lin CY, Huang SM. Childhood albuminuria and chronic kidney disease is associated with mortality and end-stage renal disease. Pediatr Neonatol 2016;57:280-7. https://doi.org/10.1016/j.pedneo.2015.09.013
  32. el Hag AI, el Seed AM, Mustafa MD. Proteinuria in Sudanese children. Ann Trop Paediatr 1984;4:99-102. https://doi.org/10.1080/02724936.1984.11748317