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首页> 外文期刊>Clinical kidney journal. >Random spot urine protein/creatinine ratio: a reliable method for monitoring lupus nephritis?
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Random spot urine protein/creatinine ratio: a reliable method for monitoring lupus nephritis?

机译：随机尿蛋白/肌酐比值：监测狼疮肾炎的可靠方法吗？

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Background Lupus nephritis (LN) is a common and severe manifestation of systemic lupus erythematosus (SLE) that can lead to end-stage renal disease. According to the Kidney Disease Outcomes Global Improving clinical Guidelines for Glomerulonephritis, spot urine protein/creatinine (P/C) ratio should be used for monitoring LN. However, some reports write that the random spot urine P/C ratio is unreliable in monitoring proteinuria in SLE glomerulonephritis patients. The aim of this study was to evaluate the agreement of these two assay methods. Methods The prospective observational study was performed. Fifty-three paired (total 106) spot and 24-h urine collections were evaluated. Statistical analysis: SPSS 20.0. Results Paired samples t-test did not reveal significant differences between the two-paired assay methods (spot P/C ratio versus 24-h proteinuria and 24-h P/C ratio) and a statistically significant correlation was observed between them: Pearson's coefficient of 0.847 (P 0.001) and 0.863 (P 0.001), respectively. However, after stratifying by degrees of proteinuria, a poor correlation was found in the range of 500 mg/day and only 26.6% of 24-h P/C ratio was explained by the spot P/C ratio. Adding to this, for proteinuria range between 500 and 1000 mg/day, there was no correlation (Pearson's ?0.098; P 0.05). In fact, only 1% of 24-h measurements could be explained by the spot P/C ratio. Conclusions Our study demonstrated a good correlation between 24-h proteinuria and random P/C ratio among patients with LN. However, this correlation was poor for proteinuria under 500 mg/day and did not exist in a range between 500 and 1000 mg/day. This finding is of greater importance because this range is quite common in patients with LN remission. Until further clarification, to the best of our knowledge, we maintain reluctant to completely substitute the 24-h collection by the P/C ratio especially when a renal flare is suspected, or before any change in therapy.
机译：背景狼疮性肾炎（LN）是系统性红斑狼疮（SLE）的常见和严重表现，可导致终末期肾脏疾病。根据《肾脏疾病结果全球肾小球肾病临床改善指南》，应使用尿液蛋白/肌酐（P / C）比值监测LN。但是，一些报告写道，随机监测的尿液点尿/尿比在SLE肾小球肾炎患者中监测蛋白尿并不可靠。这项研究的目的是评估这两种测定方法的一致性。方法进行前瞻性观察研究。评价了53对配对尿样（总共106个）和24小时尿样。统计分析：SPSS 20.0。结果配对样本t检验未显示两种配对测定方法之间的显着差异（点P / C比值与24小时蛋白尿和24小时P / C比值），并且观察到它们之间具有统计学意义的相关性：皮尔森系数分别为0.847（P <0.001）和0.863（P <0.001）。但是，在按蛋白尿程度分层后，发现在<500 mg /天的范围内相关性较差，并且仅通过点P / C比解释了24小时P / C比的26.6％。另外，对于蛋白尿范围在500至1000 mg / day之间，则没有相关性（Pearson's 0.098; P> 0.05）。实际上，24小时测量中只有1％可以用点P / C比来解释。结论我们的研究表明LN患者24小时蛋白尿与随机P / C比之间存在良好的相关性。但是，这种相关性对于低于500 mg / day的蛋白尿较差，并且在500至1000 mg / day的范围内不存在。这一发现具有更大的重要性，因为该范围在LN缓解患者中非常普遍。据我们所知，在进一步澄清之前，我们一直不愿意用P / C比完全替代24小时采集，特别是在怀疑有肾脏耀斑或治疗发生任何变化之前。

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