Establish Albumin-creatinine Ratio Reference Valueof Adults in the Rural Area of Hebei Province

Area of Science:

• Nephrology
• Public Health
• Clinical Chemistry

Background:

• Establishing population-specific reference values for urinary albumin-creatinine ratio (ACR) is crucial for accurate diagnosis of kidney disease.
• Previous studies have not defined ACR reference values for the rural population in Hebei province, China.

Purpose of the Study:

• To determine the normal upper limit of ACR in apparently healthy rural residents of Hebei province.
• To estimate the prevalence of albuminuria in this population using the established reference values.

Main Methods:

• A cohort of 5154 participants was screened, with 1168 apparently healthy individuals selected after excluding comorbidities and low eGFR.
• Urine albumin and serum creatinine were measured using immunoturbidimetric and Jaffe's kinetic methods, respectively, from morning spot-urine samples.
• The 95th percentile of ACR in the healthy cohort was defined as the normal upper limit.

Main Results:

• The established ACR normal upper limit was 28.71 mg/g (3.25 mg/mmol) for males and 31.85 mg/g (3.60 mg/mmol) for females.
• The age- and gender-standardized prevalence of albuminuria in rural Hebei was found to be 12.9% based on these new reference values.
• The determined ACR reference values for this rural population are higher compared to established Western population values.

Conclusions:

• The study successfully established ACR reference values for the rural population of Hebei province.
• The prevalence of albuminuria in rural Hebei is significant, highlighting the need for targeted screening and management.
• The higher ACR reference values suggest potential differences in kidney health or environmental factors compared to Western populations.