Improving the urine spot protein/creatinine ratio by the estimated creatinine excretion to predict proteinuria in pediatric kidney transplant recipients

Background Since the daily creatinine excretion rate (CER) is directly affected by muscle mass, which varies with age, gender, and body weight, using the spot protein/creatinine ratio (Spot P/Cr) follow‐up of proteinuria may not always be accurate. Estimated creatinine excretion rate (eCER) can be c...

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Bibliographic Details
Published in:Pediatric transplantation 2021-11, Vol.25 (7), p.e14142-n/a
Main Authors: Incir, Said, Tasdemir, Mehmet, Kocak, Burak, Yelken, Berna, Arpali, Emre, Akyollu, Basak, Palaoglu, Kerim Erhan, Baygul, Arzu, Bilge, Ilmay, Turkmen, Aydin
Format: Article
Language:English
Subjects:
accuracy
Bias
Biomarkers - urine
Body weight
Child
Children
Creatinine
Creatinine - urine
creatinine excretion rate
Excretion
Female
Humans
Kidney Function Tests
Kidney Transplantation
Kidney transplants
Male
Pediatrics
Population studies
Postoperative Complications - diagnosis
protein excretion rate
Proteins
Proteinuria
Proteinuria - diagnosis
protein‐to‐creatinine ratio
Statistical analysis
Urine
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Summary:Background Since the daily creatinine excretion rate (CER) is directly affected by muscle mass, which varies with age, gender, and body weight, using the spot protein/creatinine ratio (Spot P/Cr) follow‐up of proteinuria may not always be accurate. Estimated creatinine excretion rate (eCER) can be calculated from spot urine samples with formulas derived from anthropometric factors. Multiplying Spot P/Cr by eCER gives the estimated protein excretion rate (ePER). We aimed to determine the most applicable equation for predicting daily CER and examine whether ePER values acquired from different equations can anticipate measured 24 h urine protein (m24 h UP) better than Spot P/Cr in pediatric kidney transplant recipients. Methods This study enrolled 23 children with kidney transplantation. To estimate m24 h UP, we calculated eCER and ePER values with three formulas adapted to children (Cockcroft‐Gault, Ghazali‐Barratt, and Hellerstein). To evaluate the accuracy of the methods, Passing‐Bablok and Bland‐Altman analysis were used. Results A statistically significant correlation was found between m24 h UP and Spot P/Cr (p 
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.14142