Abstract:
Albuminuria standardization is a key issue to produce reliable and equivalent results between laboratories. We investigated whether official recommendations on albuminuria harmonization are followed in the literature. The PubMed database was searched from June 1 to September 26, 2021. The search terms included urine albumin, urine albumin-to-creatinine ratio (uACR), and albuminuria. A total of 159 articles were considered eligible; 50.9 % reported the type of urine collection. Specifically, 58.1 % collected a random spot urine specimen, 21 % collected a first morning void, and 6.2 % collected a 24-h specimen. Overall, 15 % of articles reported data on sample shipping, storage, and centrifugation and 13.3 % mentioned the preanalytical phase without any data on albuminuria. The method for albuminuria was properly described in 31.4 % of articles; of these, 54.9 % used immunological methods, and 8.9 % contained errors or missing data. Most articles (76.7 %) expressed test results as albuminuria-to-creatininuria ratio. Different decision levels were utilized in 130 articles; of these, 36 % used a decision level of ≤30 mg/g creatininuria and 23.7 % used three decision levels (≤30, 30-300, and ≥300 mg/g). The failure to follow guidelines on albuminuria harmonization was mainly found in the preanalytical phase. The poor awareness of the importance of preanalytical steps on test result may be a possible explanation.
摘要:
白蛋白尿标准化是在实验室之间产生可靠和等效结果的关键问题。我们调查了文献中是否遵循有关白蛋白尿协调的官方建议。PubMed数据库的检索时间为2021年6月1日至9月26日。搜索词包括尿白蛋白,UACR,和蛋白尿。共有159篇文章被认为是合格的;50.9%的人报告了尿液收集的类型。具体来说,58.1%随机采集了点尿标本,21%的人收集了第一个早晨的空隙,6.2%的人收集了24小时的样本。总的来说,15%的文章报告了样品运输数据,storage,和离心,13.3%提到分析前阶段,没有任何白蛋白尿数据。31.4%的文章对蛋白尿的方法进行了适当描述;其中,54.9%使用免疫学方法,8.9%包含错误或缺失数据。大多数文章(76.7%)将测试结果表示为蛋白尿与肌酐尿的比率。在130篇文章中使用了不同的决策级别;其中,36%使用≤30mg/g肌酐尿的决策水平,23.7%使用三个决策水平(≤30、30-300和≥300mg/g)。未能遵循蛋白尿协调指南主要是在分析前阶段发现的。对预分析步骤对测试结果的重要性认识不足可能是一个可能的解释。