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Reference values for urinary protein, albumin, beta 2-microglobulin, and the alpha 1-microglobulin-to-creatinine

Shojiro Okamoto1, Takeshi Matsuyama2, Riku Hamada3

  • 1Department of Pediatrics, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan.

Clinical and Experimental Nephrology
|September 7, 2023
PubMed

Insights

This study establishes crucial reference values for urinary protein-to-creatinine ratio (PCR) and albumin-to-creatinine ratio (ACR) in Japanese children. These findings provide essential benchmarks for assessing kidney health in pediatric populations.

Area of Science:

  • Pediatric Nephrology
  • Clinical Chemistry
  • Biomarker Research

Background:

  • Urinary protein, albumin, and low-molecular weight protein ratios to creatinine are vital markers for chronic kidney disease (CKD).
  • Established reference values for these urinary markers are lacking in Japanese children, hindering accurate pediatric CKD assessment.
  • This study addresses the need for specific reference values in this demographic.

Purpose of the Study:

  • To establish reference values for urinary protein-to-creatinine ratio (PCR), albumin-to-creatinine ratio (ACR), beta 2-microglobulin-to-creatinine ratio (BMCR), and alpha 1-microglobulin-to-creatinine ratio (AMCR) in Japanese children.
  • To provide a basis for early detection and monitoring of kidney disease in pediatric populations in Japan.

Main Methods:

  • Random collection of first morning urine samples from 1712 Japanese children aged 3 to 17 years during mass screenings.
  • Determination of reference values using the 97.5th percentile for each urinary marker-to-creatinine ratio.
  • Analysis of age-related trends in marker concentrations.

Main Results:

  • Urinary protein-to-creatinine ratio (PCR) and albumin-to-creatinine ratio (ACR) showed age-related decreases.
  • Established reference values: PCR 0.12 g/gCr, ACR 35 mg/gCr for the entire cohort.
  • Age-specific reference values for BMCR and AMCR were determined, with lower values for children aged 6 years and older.

Conclusions:

  • This study provides the first comprehensive reference values for PCR, ACR, BMCR, and AMCR in Japanese children.
  • These established values are critical for accurate diagnosis and management of kidney conditions in pediatric patients.
  • The findings support improved pediatric nephrology care through standardized biomarker assessment.
Abstract

Keywords:
ChildrenCongenital anomalies of kidney and urinary tractReference values of urinary markerUrinary albuminUrinary beta 2-microglobulinUrinary proteinUrinary screening

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