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논문분류	춘계학술대회 초록집
제목	Converting Urine Protein-to-Creatinine Ratio to Urine Albumin-to-Creatinine Ratio: Evaluating the Diagnostic Accuracy of Simple versus Complex Formulas in Albuminuria Detection
저자	Joseph Kuo
출판정보	2024; 2024(1):
키워드
초록	Objectives: Recent studies indicate that converting the urine protein-to-creatinine ratio (uPCR) to the urine albumin-to-creatinine ratio (uACR) using formulas could compensate for the absence of uACR in performing risk assessments for Chronic Kidney Disease (CKD). This study evaluates the effectiveness of both a simple and a complex formula in screening for albuminuria using uPCR in a Taiwanese cohort. Methods: Our study included individuals aged 18-90 years who had at least two sets of simultaneous uPCR and uACR measurements from the ignite Hyper-intelligence (iHi) Data Platform at China Medical University Hospital. We excluded urine samples with creatinine levels below 30 or above 300 mg/dL. Simple and complex formulas were used to estimate the uACR based on uPCR (Figure). The correlation and agreement between actual and predicted uACR values were assessed using Pearson method and the Bland-Altman approach. For patients whose predicted uACR failed to detect albuminuria as per the actual uACR in the first paired measurements, we subsequently calculated the positive detection rate of albuminuria within the 90, 180, and 365 follow-up timeframes. Results: This study examined 2,024 patients, with a median age of 60.6 years, and a 65% male majority. Correlation coefficients between actual uACR and uACR predicted by simple and complex formulas were 0.953 and 0.973, respectively. The Bland-Altman plots (Figure) summarize the patterns of agreement and proportional bias. Among 1,225 patients with initial actual uACRs exceeding 30 mg/g creatinine, we found false negative rates (FNR) of 2.0% with the simple formula and 7.6% with the complex formula. During a 90-day follow-up, 55.6% of subsequent available urine samples indicated albuminuria when analyzed using the simple formula, compared to 40.5% identified by the complex formula (Table). Conclusions: In the Taiwanese population, using a simple formula to predict uACR from uPCR for albuminuria screening is practical, given its low FNR and cost-effectiveness.
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