New Possibilities in Quantitative Assessment of Albuminuria in Patients with Atrial Fibrillation and Chronic Kidney Disease

Abstract

Aim. To evaluate the relationship between albumin to creatinine ratio (ACR) in a single and 24-hours urine spots and chronic kidney disease (CKD) progression pace in patients with atrial fibrillation, CKD and diabetes mellitus.Material and methods. 60 patients with atrial fibrillation (AF) and CKD were enrolled, study duration was 15 months. The patients were divided into two groups depending on the presence of DM. Total number of ACR tests was 170, dynamics of CKD progression was estimated with CKD-EPI formula for first visit and 15th month’s follow-up.Results. The median score of CHA2DS2VASс scale was 4 [3;5]. The risk of hemorrhagic complications in both groups was low (median score 1 [1;1]. There is a strong statistically significant correlation between ACR in a single and 24-hours urine spots (p<0.001). No significant changes in kidney function within 15 months were found (GFR 53 [46;59] ml/min/1.73 m2 vs 50.5 [45.63] ml/min/1.73 m2 for patients with diabetes mellitus [DM] [p=0.94] and GFR 52.5 [46.58] ml/min/1.73 m2 vs 50 [44.58] ml/min/1.73 m2 for patients without DM [p=0.711]). When comparing the renal function of patients with and without DM after 15 months statistically significant differences were also not found (p = 0.510).Conclusion. In respect that assessment of single sample ACR is much more practical and reliable, this method might replace traditional 24-hours urine assessment in future. However, due to the small sample size and the presence of wide discrepancies in individual cases, which can be associated with preanalytical errors in urine collection, large randomized clinical trials are needed to confirm the obtained data.

Keywords

• albumin to creatinine ratio
• chronic kidney disease
• atrial fibrillation
• diabetes mellitus
• albuminuria