Kim et al reported the impact of nonalbumin proteinuria on prediction of nephropathy progression in a patient with Type 2 diabetes. The combination of albuminuria and nonalbumin proteinuria can improve risk stratification. The authors are from Pusan National University and Kim Yong Ki Internal Medicine Clinic in South Korea.
Patient selection: type 2 diabetes with diabetic nephropathy
Parameters:
(1) urine total protein in mg/dL
(2) urine albumin in mg/dL
(3) urine non-albumin protein in mg/dL
(4) urine creatinine in mg/dL
urine non-albumin protein in mg/dL =
= (urine total protein in mg/dL) - (urine albumin in mg/dL)
albumin to creatinine ratio in mg/g = ACR =
= (urine albumin) / (urine creatinine) * 1000
nonalbumin to creatinine ratio in mg/g = NACR =
= (urine nonalbumin protein) / (urine creatinine) * 1000 =
= (total urine protein clearance) - ACR
|
ACR
|
NACR
|
5-Year CKD Progression
|
5-Year Accelerated GFR Decline
|
|
< 30
|
< 120
|
0.01
|
0.20
|
|
< 30
|
>= 120
|
0.18
|
0.29
|
|
>= 30
|
< 120
|
0.10
|
0.15
|
|
>= 30
|
>= 120
|
0.22
|
0.35
|
