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Microalbuminuria as a possible marker of risk of Balkan endemic nephropathy
Author(s) -
IMAMOVIC GORAN,
BATUMAN VECIHI,
SINANOVIC OSMAN,
TRNACEVIC SENAID,
MESIC ENISA,
ZEREM ENVER,
OSMANOVIC ENES
Publication year - 2008
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2008.01007.x
Subject(s) - microalbuminuria , medicine , odds ratio , creatinine , confidence interval , interquartile range , population , albuminuria , diabetic nephropathy , nephropathy , urology , gastroenterology , renal function , endocrinology , diabetes mellitus , kidney , environmental health
SUMMARY: Aim: To evaluate whether microalbuminuria could be a marker of early tubular damage in individuals at risk of developing Balkan endemic nephropathy (BEN). Methods: A cross‐sectional study was used to determine urinary albumin‐to‐creatinine ratio (UACR) in a test group of 61 participants from a BEN endemic region and control group of 64 participants from a nearby non‐endemic region, both recruited from the general population of Bosnia and Herzegovina. The correlation between UACR and urinary b2 microglobulin‐to‐creatinine ratio (UBCR) and the receiver operating characteristic curve for UACR were analyzed in the test groups of 58 participants. The correlation analysis was also performed in a subset of nine subjects with elevated UBCR. Results: Medians, interquartile ranges and confidence intervals (CI) for medians of UACR in the test and control groups were 2 mg/mmol, 0.975–8.247 mg/mmol, 1.3472–3.2691 mg/mmol and 1 mg/mmol, 0.695–1.41 mg/mmol, 0.8466–1.2053 mg/mmol, respectively ( P = 0.0001). Microalbuminuria was found in 30 of the 61 examinees in the test group, in contrast to six of the 64 examinees in the controls ( P < 0.0001). Participants from the endemic region had 9.3 times the odds of having microalbuminuria in contrast to participants from the non‐endemic region. Pearson's correlation coefficients r of the log‐transformed ratios and Kendall–tau coefficients of rank correlation in the group of 58 and in a subset of nine subjects with elevated UBCR were: 0.55 ( P < 0.0001); 0.317 ( P = 0.0005) and 0.59 ( P = 0.045); 0.48 ( P = 0.037), respectively. The area under the curve for UACR was 0.882 ( P = 0.0001), sensitivity 100% and specificity 67.3%. Conclusion: Microalbuminuria may be a useful marker of early tubular injury in individuals at risk of developing BEN.