TY - JOUR
T1 - Validity of random urines to quantitate proteinuria in children with human immunodeficiency virus nephropathy
AU - Abitbol, Carolyn L.
AU - Strauss, José
AU - Zilleruelo, Gastón
AU - Montané, Brenda
AU - Rodriguez, Élena
N1 - Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1996
Y1 - 1996
N2 - Accurate assessment of proteinuria in pediatric patients infected with the human immunodeficiency virus (HIV) is limited by constraints imposed by timed urine collections and low creatinine excretion in very ill patients with low muscle mass. We therefore sought to validate the use of random urine specimens to quantitate total protein and creatinine excretion in a population of 236 HIV-positive children. A mathematical derivation for estimating urine volume (V) was constructed. The accuracy of the final calculation [V = 832 (kL/Ucr)BSA] (where k = constant, L body length, UCr urine creatinine and BSA body surface area) was tested by regression analysis comparing the calculated and measured volume of 31 urines from ambulatory HIV-negative patients. The correlation coefficient was highly significant (r = 0.77, P ≤ 0.0001). The relationship was also applied to 23 timed urine specimens from HIV-positive patients with similar significance (r = 0.87, P < 0.0001). A regression analysis of measured proteinuria against the urine protein: creatinine ratio (U(pr)/U(Cr)) in these same urines from the HIV-positive patients yielded a significant relationship both in the linear (r = 0.95, y = 0.4x) and the logarithmic regression (r = 0.97, y = x + 0.4). These data support the use of random U(pr)/U(Cr) ratios to estimate daily proteinuria in HIV-infected pediatric patients despite low creatinine excretion rates. The previously accepted values continue to apply, with U(pr)/U(Cr) ≤ 2.0 considered normal and > 2.0 representative of nephrotic proteinuria.
AB - Accurate assessment of proteinuria in pediatric patients infected with the human immunodeficiency virus (HIV) is limited by constraints imposed by timed urine collections and low creatinine excretion in very ill patients with low muscle mass. We therefore sought to validate the use of random urine specimens to quantitate total protein and creatinine excretion in a population of 236 HIV-positive children. A mathematical derivation for estimating urine volume (V) was constructed. The accuracy of the final calculation [V = 832 (kL/Ucr)BSA] (where k = constant, L body length, UCr urine creatinine and BSA body surface area) was tested by regression analysis comparing the calculated and measured volume of 31 urines from ambulatory HIV-negative patients. The correlation coefficient was highly significant (r = 0.77, P ≤ 0.0001). The relationship was also applied to 23 timed urine specimens from HIV-positive patients with similar significance (r = 0.87, P < 0.0001). A regression analysis of measured proteinuria against the urine protein: creatinine ratio (U(pr)/U(Cr)) in these same urines from the HIV-positive patients yielded a significant relationship both in the linear (r = 0.95, y = 0.4x) and the logarithmic regression (r = 0.97, y = x + 0.4). These data support the use of random U(pr)/U(Cr) ratios to estimate daily proteinuria in HIV-infected pediatric patients despite low creatinine excretion rates. The previously accepted values continue to apply, with U(pr)/U(Cr) ≤ 2.0 considered normal and > 2.0 representative of nephrotic proteinuria.
KW - Human immunodeficiency virus nephropathy
KW - Proteinuria
KW - Urine protein: creatinine ratio
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U2 - 10.1007/s004670050169
DO - 10.1007/s004670050169
M3 - Article
C2 - 8897564
AN - SCOPUS:0029742330
VL - 10
SP - 598
EP - 601
JO - Pediatric Nephrology
JF - Pediatric Nephrology
SN - 0931-041X
IS - 5
ER -