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Consecutive First-Morning Urine Samples to Measure Change in the Albumin-to-Creatinine Ratio: A Pilot Study of a Home Urine Collection Protocol

Overview of attention for article published in Canadian Journal of Kidney Health and Disease, February 2016
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Citations

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3 Dimensions

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Title
Consecutive First-Morning Urine Samples to Measure Change in the Albumin-to-Creatinine Ratio: A Pilot Study of a Home Urine Collection Protocol
Published in
Canadian Journal of Kidney Health and Disease, February 2016
DOI 10.1186/s40697-016-0095-8
Pubmed ID
Authors

Jessica M. Sontrop, Amit X. Garg, Lihua Li, Kerri Gallo, Virginia Schumann, Jennifer Winick-Ng, William F. Clark, Matthew A. Weir

Abstract

Multiple first-morning urine samples are recommended for measuring the urine albumin-to-creatinine ratio (ACR); however, this can be challenging in community-based research. The objectives of the study are to pilot-test a home urine collection protocol and examine how the average and variance of ACR varied with the number of urine collections and time to laboratory analysis. This is a prospective observational pilot study. This study was conducted in London, Ontario, Canada at the London Health Sciences Centre (2012-2013). The patients were adults with chronic kidney disease (mean estimated glomerular filtration rate, 36 mL/min/1.73 m(2)). Participants collected a first-morning 20-mL urine sample on three consecutive days. This process was repeated after 3 months. Samples were picked up by hospital courier and analyzed for ACR on the same day; additional aliquots were analyzed after a delay of 24-48 h (stored at 4 °C) and 3-9 months (stored at -80 °C). The geometric mean of the percentage change in ACR between baseline and 3 months was calculated and compared between single samples and the average of two vs. three consecutive samples. Of 31 patients enrolled, 26 (83.9 %) submitted all six urine samples. The geometric mean of ACR for three consecutive samples at baseline was 87, 83, and 80 mg/mmol, and the corresponding percentage increase from baseline to 3 months was 15 % (95 % confidence interval (CI), -9 to 46 %), 33 % (95 % CI, 10 to 59 %), and 22 % (95 % CI, -6 to 57 %). Compared with single urine collections at baseline and follow-up, averaging ACR values from two consecutive first-morning urine samples improved the sample variance and reduced the required sample size to detect a given treatment effect by approximately 30 %. No further gain in statistical efficiency was achieved with three urine samples. Results were similar when the laboratory analysis was delayed by 24-48 h, but a delay of 3-9 months resulted in systematic overestimation of the ACR. Our study's generalizability is limited by its small sample size and reliance on a clinic-based population from a single urban center. We successfully used a home urine collection protocol to obtain multiple first-morning urine samples in patients with chronic kidney disease. Statistical efficiency was improved by averaging ACR values from two consecutive first-morning urine samples at baseline and follow-up.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 9 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 9 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 2 22%
Other 1 11%
Student > Doctoral Student 1 11%
Student > Bachelor 1 11%
Researcher 1 11%
Other 2 22%
Unknown 1 11%
Readers by discipline Count As %
Medicine and Dentistry 4 44%
Psychology 1 11%
Chemistry 1 11%
Engineering 1 11%
Unknown 2 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 March 2016.
All research outputs
#11,071,882
of 17,687,978 outputs
Outputs from Canadian Journal of Kidney Health and Disease
#292
of 384 outputs
Outputs of similar age
#143,548
of 273,036 outputs
Outputs of similar age from Canadian Journal of Kidney Health and Disease
#1
of 1 outputs
Altmetric has tracked 17,687,978 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 384 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.4. This one is in the 20th percentile – i.e., 20% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 273,036 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 44th percentile – i.e., 44% of its contemporaries scored the same or lower than it.
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