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논문분류	춘계학술대회 초록집
제목	Comparison of predictive performance between spot urine albuminuria and proteinuria for kidney failure risk in patients with chronic kidney disease
저자	Hyoungnae Kim
출판정보	2023; 2023(1):
키워드
초록	Objectives: Although albuminuria is the gold standard for defining chronic kidney disease (CKD) and is earlier sign of diabetic nephropathy than proteinuria, total proteinuria has been also widely used in real-world clinical practice. Moreover, superiority of prognostic performance of albuminuria over proteinuria is still inconclusive in patients who are already diagnosed with CKD and have overt albuminuria. Therefore, this study aimed to compare predictive performance between albuminuria and proteinuria in these patients. Methods: From KNOW-CKD cohort, we included 2115 patients diagnosed with CKD grade 1 to 5 not requiring kidney replacement therapy. We measured spot urine albumin-to-creatinine ratio (ACR) and protein-to-creatinine ratio (PCR) using same urine samples. We calculated Kidney Failure Risk Equation (KFRE) scores using both ACR and PCR. The primary outcome was kidney failure with replacement therapy (KFRT). Results: The mean age was 53.6 years and 61.1% of patients were men. The median levels of ACR and PCR were 354.1 mg/g and 0.5 g/g, respectively. During the median follow-up of 5.8 years, 615 (29.1%) KFRT events occurred. When adjusted for age, sex, and estimated glomerular filtration rate, time-dependent area under receiver operation curve (AUROC) of ACR [0.962; 95% confidence interval (CI), 0.952-0.972] for 2-year KFRT was similar with that of PCR (0.963; 95% CI, 0.953-0.973). Using PCR instead of ACR when calculating KFRE score, the AUROC of KFRE score did not differ. In subgroup analyses, the AUROCs between ACR and PCR were comparable in all subgroups according to cause of CKD, CKD grade, and amount of albuminuria. Conclusions: ACR and PCR showed similar predictive performance for KFRT in patients with CKD. Therefore, both markers could be useful metrics in patients who are already diagnosed with CKD.
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