• Journal of Veterinary Clinics
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• v.20 no.4
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• pp.431-436
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• 2003

The purpose of this study is to evaluate urine protein-to-creatinine ratio as a parameter for early detection of nephrotic syndrome and as a parameter for monitoring effectiveness in early course of treatment. Nine healthy dogs were sensitized by intravenous injection with 1 $\mu$g of endotoxin and 5 mg of native bovine serum albumin. After 1 week, 120 mg of cationized bovine serum albumin was injected intravenously 5 times a week. Among nine dogs, five dogs were confirmed as having developed glomerulonephritis and nephrotic syndrome by increase of urine protein-to-creatinine ratio(>1.0), hypoalbuminemia (<1.5 g/dl), hypercholesterolemia (> 240 mg/dl) and azotemia (BUN>40 mg/dl). During the induction of glomerulonephritis and the progression to nephrotic syndrome, the increase of urine protein-to-creatinine ratio was firstly detected. 1 to 4 weeks later, hypoalbuminemia, hypercholesterolemia, and azotemia were detected. Prednisolone (2.2 mg/kg, bid) was administered orally to the dogs with induced nephrotic syndrome. In early stage of treatment, the increase of serum albumin and decrease of serum cholesterol were detected. 1 to 4 weeks later, decrease of urine protein-to-creatinine ratio was detected. It was concluded that urine protein-to-creatinine ratio is a useful parameter for early detection of nephrotic syndrome, and serum albumin and cholesterol are useful parameters for the monitoring in early course of treatment in nephrotic syndrome.

• 대한예방의학회:학술대회논문집
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• 1994.02b
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• pp.158-163
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• 1994

Slightly elevated urinary albumin excretion rate (microalhuminuria) is a marker of early diabectic nephropathy, but it is unclear if the established definition of microalbuminuria ($20-200{\mu}g/min$) is correct for children and adolescents. We investigated th.: albumin excretion rate, albumin/creatinine ratio and urinary albumin concentration in 150 healthy schoolchildren and adolescents to (a) obtain a reterence value for albumin excretion rate, (b) relate albumin excretion to pubertal stages and (c) evaluate albumin/creatinine ratio and morning albumin concentration as screening methods for elevated albumin excretion rate. Albumin concentration was measured by immunoturbidimetry in timed overnight urine samples. The albumin excretion showed a skewed distribution (geometric mean $3.2{\mu}g/min$, 95 percentile ($15.1{\mu}g/min$). In girls. a peak in the albumin excretion rate was found at the pubertal stage 4 (Tanner) and in boys at stage 5. Albumin/creatinine ratio of 2.5 mg/mmol as a screening level for elevated albumin excretion ($15{\mu}g/min$) showed a high positive (0.88) and negative (0.99) predictive value.

• Journal of Veterinary Clinics
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• v.40 no.6
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• pp.399-407
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• 2023

Chronic kidney disease (CKD) occurs in more than 15% of the dogs over 10 years of age and causes irreversible renal function deterioration. Therefore, it is important to diagnose CKD early and treat the disease properly. The purpose of this study aimed to to evaluate the clinical utility of urine albumin/creatinine ratio (ACR) using POC (point-of-care) device as an early detection urinary biomarker in CKD dogs and to confirm the correlation between ACR and other known CKD biomarkers. Urine and serum samples were obtained from 50 healthy dogs and 50 dogs with CKD. Serum blood urea nitrogen (BUN), creatinine, and symmetric dimethylarginine (SDMA) concentrations, and urine protein creatinine ratio (UPC) were measured. Urine specific gravity (USG) was evaluated using refractometer, and ACR was measured using an i-SENS A1Care analyzer. The ACR values of dogs with CKD were significantly different from those of healthy dogs (p < 0.001), as with other renal biomarkers. ACR showed significant differences between healthy dogs and dogs with CKD at every IRIS stage (p < 0.005), whereas no significant differences were observed between dogs with CKD IRIS stage I and healthy dogs with UPC. There are significant positive correlation between ACR and BUN (r = 0.611, p < 0.001), creatinine (r = 0.788, p < 0.001), SDMA (r = 0.747, p < 0.001), and UPC (r = 0.784, p < 0.001), and significant negative correlation between ACR and USG (r = -0.700, p < 0.001). In receiver operator characteristic curve analysis, the area under the curve (AUC) was 0.982 (95% CI 0.963-1.000, p < 0.001), with an optimal cut-off value of 64.20 mg/g (94% sensitivity and 94% specificity). Thus, ACR is a useful urinary biomarker for the early diagnosis of proteinuria in CKD and combined use of ACR and other renal biomarkers may be helpful for early diagnosis and prevention of CKD in dogs.

• Clinical and Experimental Pediatrics
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• v.53 no.9
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• pp.840-844
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• 2010

Purpose: Microalbuminuria is defined as increased urinary albumin excretion (30-300 mg/day) or microalbumin/creatinine ratio (30-300 mg/g) in a spot urine sample. Although microalbuminuria is a predictor of clinical nephropathy and cardiomyopathy, few studies have investigated microalbuminuria in children with urinary tract infection (UTI). Therefore, we compared the spot urine microalbumin/creatinine ratio in pediatric UTI patients with that of control subjects. Methods: We investigated the correlation between the ratio in children with UTI and age, height, weight, blood pressure, glomerular filtration rate (GFR), hematuria, vesicoureteral reflux, renal parenchymal defect, and renal scar, and its predictability for UTI complications. Results: We studied 66 patients (42 boys, 24 girls) and 52 healthy children (24 boys, 28 girls). The mean microalbumin/creatinine ratio in UTI patients was statistically significantly increased compared to the control group ($340.04{\pm}321.36mg/g$ vs. $225.68{\pm}154.61mg/g$, $P$=0.0141). The mean value of spot urine microalbumin/creatinine ratio ($384.70{\pm}342.22mg/g$ vs. $264.92{\pm}158.13mg/g$, $P$=0.0341) in 1-23 months age patient group showed statistically significant increase compared to control group. Microalbumin/creatinine ratio showed negative correlation to age (r=-0.29, $P$=0.0167), body surface area (BSA) (r=-0.29, $P$=0.0173) and GFR (r=-0.26, $P$=0.0343). The presence of hematuria ($P$=0.0169) was found to be correlated. Conclusion: The spot urine microalbumin/creatinine ratio in children with UTI was significantly greater than that in normal children, and it was positively correlated with GFR. This ratio is a potential prescreening and prognostic marker in UTI patients. Further studies are required to validate the predictability of microalbuminuria in pediatric UTI patients.

• Childhood Kidney Diseases
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• v.26 no.2
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• pp.69-73
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• 2022

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.

• Korean Journal of Clinical Laboratory Science
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• v.38 no.3
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• pp.208-211
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• 2006

Microalbuminuria is most frequently caused by kidney damage from diabetes. Moreover, many other conditions can lead to kidney damage, such as high blood pressure, heart failure, cirrhosis, or systemic lupus erythematosus (SLE). The measurement of the microalbumin in urine may be useful for the early diagnosis or as a predictor of nephropathy in diabetes. The most common method for getting a quantitative measurement of urinary protein relies on a 24-hour urine collection. The result of this method is accurate. But 24hr urine collection is difficult to obtain and variations in volume are frequent. Also the patients complain about urine collection. We tried to measure reference values for microalbumin using fasting urine and compare them with the albumin/creatinine ratio using 24hr urine. The concentrations of microalbumin in fasting urine and 24hr urine were $7.1{\pm}3.8mg/L$, $5.7{\pm}2.9mg/L$ (r=0.61, p=0.27), respectively. The albumin/creatinine ratios using fasting urine and 24hr urine were $8.7{\pm}4.2{\mu}g/mg$, $8.7{\pm}4.0{\mu}g/mg$ (r=0.76, p=0.88), respectively. This study indicated that the measurement of microalbumin in fasting urine was an easy and simple method for early diagnosis or to predict nephropathy in diabetes. Thus, setting up the reference value using fasting urine may be useful in the screening test for the diabetic nephropathy patients instead of using the 24hr albumin excretion rate (AER).

• Journal of Chest Surgery
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• v.31 no.1
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• pp.32-39
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• 1998

High-dose aprotinin(Hammersmith regimen) has been widely used for years to control postoperative bleeding and reduce blood consumption in cardiac surgery but had known to cause some side-effects and had disadvantage in cost-effectiveness. The prospective controlled study of 33 patients undergoing cardiopulmonary bypass was performed to evaluate the efficacy for reducing postoperative bleeding and unfavorable effects of low-dose aprotinin. The level of hemoglobin and platelet in the blood and the amount of postoperative bleeding were assessed preoperatively, and postoperatively for the study of hemostatic function. The level of BUN and serum creatinine in the blood, levels of urine creatinine, total protein, albumin, alpha-1-microglobulin and creatinine clearance were assessed before and after the operation for the study of renal function. The aprotinin group had a significant reduction in chest tube drainage; 243$\pm$ 123 ml versus 406$\pm$303 ml(P=0.037) during 6 hours immediate-postoperatively, 494$\pm$358 ml versus 869$\pm$570 ml(P=0.045) during 24 hours postoperatively. The ratio of alpha-1-microglobulin/creatinine and microalbumin/creatinine in the urine were slightly increased in the aprotinin group postoperatively in comparison with the control group but there were no statistically significant difference(55$\pm$23 versus 24$\pm$10 in the alpha-1-microglobulin/creatinine, 56$\pm$19 versus 38$\pm$25 in the microalbumin/creatinine at post- operative 3rd day). There were no significant difference between two groups in other parameters of renal function, too. This study showed that low-dose aprotinin is an effective means of reducing postoperative bleeding without inducing significant renal dysfunction.

• The Journal of Internal Korean Medicine
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• v.43 no.5
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• pp.1037-1044
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• 2022

Objective: This study was conducted to investigate whether acupuncture and moxibustion treatment could improve proteinuria in immunoglobulin A nephropathy. Methods: A 25-year-old man diagnosed with immunoglobulin A nephropathy had severely increased proteinuria. We conducted acupuncture treatment and moxibustion treatment on the abdominal area between the abdominal aorta and kidney at level L2. Results: After five months of acupuncture and moxibustion treatment, the patient's urine albumin/creatinine ratio and urine protein/creatinine ratio had improved from 0.571 to 0.28 and 0.79 to 0.47, respectively. Conclusions: This case report suggests that acupuncture and moxibustion treatment may ameliorate proteinuria in immunoglobulin A nephropathy.

• Childhood Kidney Diseases
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• v.7 no.2
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• pp.150-156
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• 2003

Purpose : Efforts to predict the clinicopathological outcome of IgA nephropathy have been made but have yielded conflicting results and have not helped in deciding the appropriate timing of the renal biopsy. In this study, we reviewed the predictive factors of clinicopathological outcome for finding out the criteria of renal biopsy timing of IgA nephropathy. Methods : Forty children diagnosed with biopsy proven IgA nephropathy at Wonju Christian Hospital were studied retrospectively, based on medical records. Results : Among 39 patients, 2 children progressed to higher serum creatinine level. One of them reached to the end stage renal disease within 2 year 7 months. According to WHO histopathological classification, there were 15 cases of class I, 14 cases of class II, 7 cases of class III, and 3 cases of class IV. In the mild histological classes(class I, II), gross hematuria was shown in 23 out of 29 children(P=0.02). In the severe histological classes(class III, IV), gross hematuria was noted in 4 out of 10(P>0.05). The tubulointerstitial changes were grade 1 in 24 cases, grade 2 in 4 cases, grade 3 in 8 cases, and grade 4 in 3 cases. With an increase in the tubulointerstitial grade, the 24 hour urine protein/albumin ratio increased. Serum creatinine less than 0.79 mg/dL could predict the lower grade(grade 1 and 2) of tubulointerstitial changes. But serum creatinine greater than 1.13 mg/dL could predict the higher grade(grade 3 and 4) of tubulointerstitial changes. In children with gross hematuria(n=27), serum creatinine was lower(0.78 vs 1.09 mg/dL, P=0.027), serum IgA was higher(316.3 vs 198.8 mg/dL), and the cases of lower WHO classification(I and II) were more common(23 vs 4, P=0.029) than the children with microscopic hematuria. Conclusion : Serum creatinine less than 0.79 mg/dL, macroscopic hematuria, and higher 24 hour urine protein/albumin ratio would predict the lower grade glomerulo tubulointerstitial lesion in IgA nephropathy and could be used as the criteria delaying the renal biopsy.

• Journal of Nutrition and Health
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• v.29 no.7
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• pp.788-805
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• 1996

This study was performed to investigate effects of examination-stress and protein supplementation on nitrogen metabolism and blood protein levels of Korean college students. Experiment was conducted at the beginning of a academic term and during midterm examination. During midterm examination, subjects were classified into two groups randomly : protein supplemental group(male n=6, female n=10) and placebo group(male n=4, female n=9). Protein capsules(2g/day) above 10% of indispensible amino acids requirement estimates were given to supplemental group for 10 days. At the begining of the term, male students(n=12) ingested 223.15mgN/kg/d, excreted 20.7mgN/kg/d in feces, and excreted 94.31mgN/kg/d in urine. Their apparent protein protein digestibility was 90.72%, true N balance was +100.11mgN/kg/d, and the mean maintenance N requirement of mixed Korena diet calculated was 112.13mgN/kg/d. Female students(n=19) ingested 171.44mgN/kg/d, excreted 22.13mgN/kg/d in feces, and excreted 122.92mgN/kg/d in urine. Their apparent protein digestibility was 86.76%, true N blance was + 18.39mgN/kg/d, and the mean maintenance N requirement calculated was 135.31mgN/kg/d. Blood levels of serum total protein, albumin, and BUN were within normal range. During midterm examination, fecal and urinary N excretions of female subjects(n=19) were increased, especially urea N markedly, and urea N/creatinine N ratio was augumented significantly. Apparent protein digestibility of male subjects(n=10) was decreased. Examination-stress showed 8.05mgN/kg/d (7.2%) increase of mean maintenance N requirement in male and 8.55mgN/kg/d(6.3%) increase in female students in comparison with that of the beginning of the term. Serum total protein and albumin levels showed no significant change, but serum transferrin level of female were decreased significantly. During midterm examination, females supplemented with protein capsules(2g/d)had no significant increase in fecal and urinary N excretions.