ISSN 2407-2230 | E-ISSN 1907-3062 | Universa Medicina content is searchable on DOAJ, Google Scholar, and OAI

The role of urine albumin creatinine ratio and serum β2 microglobulin as biomarkers of chronic kidney disease

Augustine Onovuakpo Eguvbe, Marcellinus Uchechukwu Nwagu, Eshiotseme Sylvester Idogun, Adeyinka Abdulrasaq Akande
Submission date: Saturday, 22 June 2019
Published date: Tuesday, 19 November 2019
DOI: http://dx.doi.org/10.18051/UnivMed.2019.v38.172-178

Abstract


BACKGROUND

Chronic kidney disease (CKD) is an increasing burden on individuals and on the healthcare system. The need to identify more sensitive and specific markers of CKD cannot be overemphasized to facilitate detection and appropriate intervention. β2 microglobulin is one of such markers of CKD. The aim of this study was to investigate the sensitivities and specificities of serum β2 microglobulin and major biochemical markers of CKD, namely creatinine and urine albumin.

 

METHODS

This was a hospital-based cross-sectional study involving 124 subjects with CKD and 124 healthy controls. Participants were categorized in two groups : group 1 the CKD based on persistent reduction in GFR <60 mL/min/1.73 m2 and group 2 healthy subjects as controls. Blood (serum) samples of participants were analyzed for serum creatinine and serum β2 microglobulin while their urine samples were analyzed for creatinine and albumin. Urine albumin creatinine ratio (UACR) was calculated from the results of the analyses.

 

RESULTS

There was a very strong positive correlation of serum β2 microglobulin with serum creatinine (r=0.750; p=0.000) and UACR (r=0.775; p=0.000), respectively. Also, there was a very strong negative correlation between serum β2 microglobulin and eGFR (r=-0.866; p=0.000). UACR had the highest sensitivity and specificity as shown by receiver operating curve characteristics (ROC) analysis.

 

CONCLUSION

In CKD, UACR and serum β2 microglobulin had the best diagnostic value. Periodic renal assessment of renal patients is mandatory as they may be affected by hidden renal dysfunction.


Keywords


β2 microglobulin; serum creatinine; urine albumin creatinine ratio; chronic kidney disease

Full Text:

PDF

References


National Kidney Foundation. Guidelines and commentaries. New York: National Kidney Foundation; 2019.

Lamb EJ, Levey AS, Stevens PE. The kidney disease improving global outcome (KDIGO) guideline update for CKD: evolution not revolution. Clin Chem 2013;59:462-5. doi: 10.1373/clinchem.2012.184259.

Ulasi II, Ijoma CK. The enormity of CKD in Nigeria: the situation in a teaching hospital in South-East Nigeria. J Trop Med 2010; Article ID 501957, 6 pages. doi:10.1155/2010/501957 501957.

Egbi OG, Okafor UH, Miebodei KE, et al. Prevalence and correlates of CKD among civil servants in Bayelsa State, Nigeria. Niger J Clin Pract 2014;17:602-7. doi: 10.4103/1119-3077.141426.

Oluyombo R, Ayodele OE, Akinwusi PO, et al. A community study of the prevalence, risk factors and pattern of CKD in Osun State, South-West Nigeria. West Afr J Med 2013;32:85-92. doi: 10.4103/1119-3077.175960.

Okwuonu CG, Chukwuonye II, Adejumo OA, et al. Prevalence of CKD and its risk factors among adults in a semi-urban community of South-East Nigeria. Niger Postgrad Med J 2017;24:81-7. doi: 10.4103/npmj.npmj_34_17.

Odubanjo MO, Oluwasola AO, Kadiri S. The epidemiology of end stage renal disease in Nigeria: the way forward. Int Urol Nephrol 2011;43:785-92. doi: 10.1007/s11255-011-9903-3.

Stanifer JW, Jing B, Tolan S, et al. The epidemiology of CKD in Sub-Saharan Africa: a systematic review and meta-analysis. Lancet Global Health 2014;2:e174-81. http://dx.doi.org/10.1016/S2214-109X(14)70002-6.

Ferguson MA, Waikar SS. Established and emerging markers of kidney function. Clin Chem 2012; 58:680-9. doi: 10.1373/clinchem.2011.167494.

Jose DH, Serafin M, Nuria F, et al. Cystatin C and â2 microglobulin markers of glomerular filtration in critically ill children. Critical Care 2007;11:59.

Stanga Z, Nock S, Medina-Escobar P, et al. Factors other than the GFR that determine the serum â2 microglobulin level. PLoS ONE 2013;8:e72073. doi: 10.1371/journal.pone.0072073.

Braga MC, Fonseca FLA, Marins MM, et al. Evaluation of â2 microglobulin, cystatin c, and lipocalin-2 as renal biomarkers for patients with Fabry disease. Nephron 2019;142:1-11. doi: 10.1159/000500570.

Delanaye P, Cavalier E, Cristol JP, et al. Calibration and precision of serum creatinine and plasma cystatin C measurement: impact on the estimation of GFR. J Nephrol 2014;27:467-75. doi: 10.1007/s40620-014-0087-7.

Fox CH, Neuhaus K, Vassalotti JA. Importance of urine albumin-creatinine ratio in the diagnosis of CKD. OA Nephrol 2013;1:21.

Currie G, Delles C. Proteinuria and its relation to cardiovascular disease. Int J Nephrol Renovasc Dis 2014; 7:13-24. doi: 10.2147/IJNRD.S40522.

Glassock RJ. Is the presence of microalbuminuria a relevant marker of kidney disease? Curr Hypertens Rep 2010;12:364-8. doi: 10.1007/s11906-010-0133-3.

Teimoury A, Iraj B, Heidari-Beni M, et al. Why 24-h urine albumin excretion rate method still is used for screening of diabetic nephropathy in Isfahan laboratories? Int J Prev Med 2014; 5: 341–7.

Browner WS, Newman TB, Hulley SB. Estimating sample size and power: applications and examples. In: Designing clinical research. 3rd ed. Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. editors. Philadelphia: Lippincott Williams & Wilkins;2007.pp.65-96.

Bargnoux AS, Kuster N, Cavalier E, et al. Serum creatinine: advantages and pitfalls. J Lab Precis Med 2018;3:71. doi: 10.21037/jlpm.2018.08.01..

Martin H. Laboratory measurement of urine albumin and urine total protein in screening for proteinuria in chronic kidney disease. Clin Biochem Rev 2011;32:97–102.

Lopez-Giacoman S, Madero M. Biomarkers in CKD, from kidney function to kidney damage. World J Nephrol 2015; 4:57-73. doi: 10.5527/wjn.v4.i1.57.

Colombo M, Looker HC, Farran B, et al. on behalf of the SUMMIT Investigators. Serum kidney injury molecule 1 and â2 microglobulin perform as well as larger biomarker panels for prediction of rapid decline in renal function in type 2 diabetes. Diabetologia 2019;62:156-68. doi: 10.1007/s00125-018-4741-9.

Shahjahan, Yasmin R, Mahsud MAJ, et al. Correlation of â2 microglobulin with serum creatinine and creatinine clearance in patients with different levels of renal function. Gomal J Med Sci 2011;9:178-82.

El-Gamasy MA, El-Naghy WS. Early predictors of renal dysfunction in paediatric patients with sickle cell disease. Indian J Nephrol 2019;29:28-33. doi: 10.4103/ijn.IJN_40_18.

Baumgarten M, Gehr T. CKD: detection and evaluation. Am Fam Physician 2011;84:1138-48.

Narva AS, Bilous RW. Laboratory assessment of diabetic kidney disease. Diabetes Spectr 2015;28:162–6. DOI: 10.2337/diaspect.28.3.162.

Wong CS, Pierce CB, Cole SR, et al. Association of proteinuria with race, cause of chronic kidney disease and glomerular filtration rate in the chronic disease in children study. Clin J Am Soc Nephrol. 2009;4:812-9. doi: 10.2215/CJN.01780408.

Nitsch 1, Grams M, Sang Y, et al. for Chronic Kidney Disease Prognosis Consortium. Association of eGFR and albuminuria with mortality and renal failure by sex: a meta-analysis. BMJ 2013;346:f324. doi: 10.1136/bmj.f324.

Gansevoort RT, Matsushita K, van der Velde M, et al. for Chronic Kidney Disease Prognosis Consortium. Lower eGFR and higher albuminuria are associated with adverse kidney outcome. Kidney Int 2011;80:93-104. doi: 10.1038/ki.2010.531.


Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 Universa Medicina

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Creative Commons License
Universa Medicina by Faculty of Medicine, Trisakti University is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Based on a work at https://univmed.org/ejurnal/index.php/medicina/