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Chronic kidney disease and measurement of albuminuria or proteinuria: a position statement.

Abstract
Optimal detection and subsequent risk stratification of people with chronic kidney disease (CKD) requires simultaneous consideration of both kidney function (glomerular filtration rate [GFR]) and kidney damage (as indicated by albuminuria or proteinuria). Measurement of urinary albuminuria and proteinuria is hindered by a lack of standardisation regarding requesting, sample collection, reporting and interpretation of tests. A multidisciplinary working group was convened with the goal of developing and promoting recommendations that achieve consensus on these issues. The working group recommended that the preferred method for assessment of albuminuria in both diabetic and non-diabetic patients is urinary albumin-to-creatinine ratio (UACR) measurement in a first-void spot urine specimen. Where a first-void specimen is not possible or practical, a random spot urine specimen for UACR is acceptable. The working group recommended that adults with one or more risk factors for CKD should be assessed using UACR and estimated GFR every 1-2 years, depending on their risk-factor profile. Recommended testing algorithms and sex-specific cut-points for microalbuminuria and macroalbuminuria are provided. The working group recommended that all pathology laboratories in Australia should implement the relevant recommendations as a vital component of an integrated national approach to detection of CKD.
AuthorsDavid W Johnson, Graham R D Jones, Timothy H Mathew, Marie J Ludlow, Stephen J Chadban, Tim Usherwood, Kevan Polkinghorne, Stephen Colagiuri, George Jerums, Richard Macisaac, Helen Martin, Australasian Proteinuria Consensus Working Group
JournalThe Medical journal of Australia (Med J Aust) Vol. 197 Issue 4 Pg. 224-5 (Aug 20 2012) ISSN: 1326-5377 [Electronic] Australia
PMID22900872 (Publication Type: Consensus Development Conference, Journal Article, Practice Guideline)
Chemical References
  • Creatinine
Topics
  • Albuminuria (diagnosis, etiology)
  • Algorithms
  • Australasia
  • Creatinine (urine)
  • Decision Support Techniques
  • Humans
  • Proteinuria (diagnosis, etiology)
  • Renal Insufficiency, Chronic (complications, diagnosis, urine)
  • Risk Assessment

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