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Reference ranges for 24-h urinary protein/creatinine ratio and urinary microalbumin/creatinine ratio in Chinese
Lele Ding1, Ying Ding2, Shanshan Xu3
1Department of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, China.
Insights
This study established reference ranges for 24-h urinary protein/creatinine ratio (24hUPCR) and urinary microalbumin/creatinine ratio (UMACR) in Chinese children. Results show these ratios vary with age, gender, and BMI, highlighting the need for age- and gender-specific pediatric cutoff values.
Area of Science:
- Pediatric Nephrology
- Clinical Chemistry
- Biomarker Research
Background:
- Urinary protein and albumin excretion are key indicators of kidney health in children.
- Establishing accurate reference ranges for 24-h urinary protein/creatinine ratio (24hUPCR) and urinary microalbumin/creatinine ratio (UMACR) is crucial for diagnosing kidney disease in pediatric populations.
- Existing reference ranges may not adequately account for demographic variations such as age, gender, and ethnicity.
Purpose of the Study:
- To investigate the age and gender characteristics of 24hUPCR and UMACR in healthy Chinese children.
- To identify related factors influencing these urinary markers.
- To establish preliminary, age- and gender-specific reference ranges for 24hUPCR and UMACR in this population.
Main Methods:
- A cohort of 200 healthy Chinese children aged 2-15 years was analyzed.
- Subjects were stratified into twelve age groups.
- Kruskal-Wallis ANOVA and Spearman correlation analyses were employed to assess relationships between urinary markers and various parameters, with 95% reference ranges calculated.
Main Results:
- Both 24hUPCR and UMACR demonstrated significant correlations with age, height, weight, and BMI (p < 0.001).
- Females exhibited higher levels of both markers compared to males (p < 0.01).
- Critical age nodes for significant changes in 24hUPCR and UMACR were identified at 6 and 8 years, respectively. Preliminary reference ranges were established, with distinct values for males and females across different age brackets (e.g., 24hUPCR < 24.34 mg/mmol for males aged 2-6 years, < 17.60 mg/mmol for males aged 6-15 years).
Conclusions:
- Pediatric 24hUPCR and UMACR levels are influenced by age, gender, anthropometric measurements, and ethnicity.
- Developing precise pediatric cutoff values that incorporate age, gender, and ethnicity is essential for optimizing the sensitivity and specificity of these biomarkers in clinical practice.
- The established reference ranges provide a foundation for improved pediatric kidney function assessment in the studied population.
Background:
The purpose of this study was to investigate the age and gender characteristics of 24-h urinary protein/creatinine ratio (24hUPCR) and urinary microalbumin/creatinine ratio (UMACR) among Chinese children and other related factors, and to establish preliminary reference ranges.
Methods:
A total of 200 healthy children aged 2-15 years were enrolled. We divided the subjects into twelve groups according to age. Kruskal-Wallis one-way ANOVA test and Spearman correlation analysis were used to compare 24hUPCR and UMACR with other variables and 95% reference range was used to establish the reference range.
Results:
24hUPCR and UMACR showed correlation with age, height, weight, and body mass index (BMI) (p < 0.001), and females had higher levels than males among all healthy children (p < 0.01). 6 and 8 years of age were the critical nodes in the change of 24hUPCR and UMACR levels, respectively. The reference ranges established based on the 200 Chinese children in this study are as follows: 24hUPCR: < 24.34 mg/mmol (male) and < 43.04 mg/mmol (female) for ≥ 2-6 years; < 17.60 mg/mmol (male) and < 22.80 mg/mmol (female) for ≥ 6-15 years.
Umacr:
< 1.53 mg/mmol (male) and < 1.74 mg/mmol (female) for ≥ 2-8 years, < 1.13 mg/mmol (male) and < 3.48 mg/mmol (female) for ≥ 8-15 years.
Conclusions:
24hUPCR and UMACR in children were correlated with age, gender, height, weight, BMI, and ethnicity. Establishing the right pediatric cutoff values that account for age, gender, and ethnicity can guarantee the sensitivity and specificity needed for clinical applications.
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