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Microalbuminuria and hyperfiltration in subjects with nephro-urological disorders

Cachat, Francois ; Combescure, Christophe ; Chehade, Hassib ; Zeier, Gregory ; Mosig, Dolores ; Meyrat, Blaise ; Frey, Peter ; Girardin, Eric

In: Nephrology Dialysis Transplantation, 2013, vol. 28, no. 2, p. 386-391

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    Titre
    • Microalbuminuria and hyperfiltration in subjects with nephro-urological disorders
    Auteur
    • Cachat, Francois. Department of Pediatrics, Division of Pediatric Nephrology, University Hospital, Lausanne, Switzerland
    • Combescure, Christophe. University Hospital, Clinical Epidemiology Unit, Geneva, Switzerland
    • Chehade, Hassib. Department of Pediatrics, Division of Pediatric Nephrology, University Hospital, Lausanne, Switzerland
    • Zeier, Gregory. Department of Pediatrics, Division of Pediatric Nephrology, University Hospital, Lausanne, Switzerland
    • Mosig, Dolores. Department of Pediatrics, Division of Pediatric Nephrology, University Hospital, Lausanne, Switzerland
    • Meyrat, Blaise. Division of Pediatric Urology, Department of Pediatrics, University Hospital, Lausanne, Switzerland
    • Frey, Peter. Division of Pediatric Urology, Department of Pediatrics, University Hospital, Lausanne, Switzerland
    • Girardin, Eric. Division of Pediatric Nephrology, Department of Pediatrics, University Hospital, Geneva, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Nephrology Dialysis Transplantation, 2013, vol. 28, no. 2, p. 386-391. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:294085
    Summary
    Background Microalbuminuria (MA) has been shown to be an early biomarker of renal damage. It is postulated that MA is the early result of hyperfiltration, which could evolve into glomerular sclerosis and renal failure if hyperfiltration is left untreated. We hypothesized that MA is a good indicator of hyperfiltration in children with kidney disorders, obviating the need to calculate the filtration fraction (FF). Methods A total of 155 children or young adults were prospectively included [42 single kidney (SK), 61 vesico-ureteral reflux, 23 obstructive uropathies, 29 other kidney diseases]. We measured inulin, para-aminohippuric acid clearances, FF and MA. Prediction of hyperfiltration was explored by studying the association between the FF and other variables such as urinary albumin (Alb), urinary albumin-creatinine ratio (ACR) and creatinine clearance. Results A significant but weak association between urinary Alb or ACR and FF was found in subjects with an SK (Spearman correlation coefficients 0.32 and 0.19, respectively). Multivariate analysis also showed that urinary Alb and ACR significantly predict FF only in subjects with an SK (r2 = 0.17, P = 0.01 and r2 = 0.13, P = 0.02, respectively). This holds true only in subjects with an SK and inulin clearance >90 mL/min/1.73 m2 (r2 = 0.41, P < 0.001). There was no association between creatinine clearance and FF. Conclusions MA is not associated with FF in our subjects with nephro-urological disorders, except in those with an SK, where the association is weak, indicating that MA is due to other mechanisms than high FF and cannot predict hyperfiltration in such groups