广东医学2025，Vol.46Issue(9)：1329-1333,5.DOI:10.13820/j.cnki.gdyx.20243671
晨尿白蛋白/肌酐比值评估慢性肾脏病患者尿蛋白排泄的临床应用研究
Clinical application of morning urinary albumin-to-creatinine ratio in assessing proteinuria in patients with chronic kidney disease
摘要
Abstract
Objective To explore the quantitative relationship between the morning urinary albumin-to-creati-nine ratio(ACR)and 24-hour urine total protein(24 h UTP),and to evaluate the clinical application of ACR in pa-tients with chronic kidney disease(CKD).Methods A total of 169 hospitalized CKD patients from October 2023 to September 2024 were enrolled.Patients were staged according to CKD diagnostic criteria.Morning urine ACR and 24 h UTP were measured and their correlation analyzed.The effects of estimated glomerular filtration rate(eGFR),sex,and age on the correlation were evaluated.Receiver operating characteristic(ROC)curves were used to determine the optimal ACR thresholds corresponding to 24 h UTP levels ≥150 mg,≥ 1 000 mg,and ≥3 500 mg.Results In the overall co-hort,morning ACR was significantly positively correlated with 24 h UTP(r=0.854,P＜0.000 1).Stratified analysis by CKD stage showed consistent positive correlations,with the strongest correlations observed in CKD stages 2 and 3,and moderate correlations in stages 1,4,and 5.Sex and age had no significant effect on the correlation between ACR and 24 h UTP.ROC analysis identified optimal ACR thresholds corresponding to 24 h UTP ≥150 mg,≥1 000 mg,and ≥3 500 mg as 80.14 mg/g,274.15 mg/g,and 1 007.67 mg/g,respectively,with high sensitivity and specificity.Conclusion Morning urinary ACR is a reliable and practical marker for assessing proteinuria in CKD patients,showing superior con-venience and clinical value compared to 24 h UTP measurement.关键词
慢性肾脏病/晨尿白蛋白/肌酐比值/24h尿蛋白定量/相关性Key words
chronic kidney disease/albumin-to-creatinine ratio/24-hour urinary protein/correlation分类
医药卫生引用本文复制引用
李慧,林文雅,蔡栋昊,肖斌,谭俊青,李蔼文..晨尿白蛋白/肌酐比值评估慢性肾脏病患者尿蛋白排泄的临床应用研究[J].广东医学,2025,46(9):1329-1333,5.基金项目
广东省医学科学研究基金项目(A2024094) （A2024094）
