Systematic review and meta-analysis of biological variation data of urine albumin, albumin to creatinine ratio and other markers in urine

TY - JOUR

T1 - Systematic review and meta-analysis of biological variation data of urine albumin, albumin to creatinine ratio and other markers in urine

AU - Aslan, Berna

AU - Carobene, Anna

AU - Jonker, Niels

AU - Galior, Kornelia

AU - Beatriz, Boned

AU - Marques-Garcia, Fernando

AU - Ricos, Carmen

AU - Bartlett, Bill

AU - Coşkun, Abdurrahman

AU - Díaz-Garzón, Jorge

AU - Fernández-Calle, Pilar

AU - González-Lao, Elisabet

AU - Simon, Margarida

AU - Sandberg, Sverre

AU - Aarsand, Aasne K.

N1 - Publisher Copyright: © 2024

PY - 2024/11/21

Y1 - 2024/11/21

N2 - Introduction Significant variations in Biological Variation (BV) estimates have been reported for urine markers. This study aimed to systematically review and critically appraise BV studies for albumin, creatinine, albumin-to-creatinine ratio (ACR), and other urine markers to perform a meta-analysis of eligible studies. Methods Publications were identified through a systematic search and evaluated using the Biological Variation Data Critical Appraisal Checklist (BIVAC). BIVAC-compliant studies (grades A-C; A being fully compliant) conducted in healthy individuals were included in the meta-analysis, providing within-subject (CVI) and between-subject (CVG) BV estimates with 95% confidence intervals for various sample collection types. Results Out of 37 studies evaluated, 16 were included (one grade A, three B, twelve C). No eligible publications were identified for meta-analysis of albumin and ACR. Limited data were available for first-morning urine specimens. A CVI between 15% and 30% was found for most measurands in 24-hour urine samples, while CVI estimates for random urine appeared higher. Conclusion Published BV studies on urine markers utilized different sample collections and reporting units. Most were considered unfit for use or ineligible for meta-analysis. Given the critical role of urine albumin and ACR in chronic kidney disease risk assessment, there is a need for more BIVAC-compliant studies.

AB - Introduction Significant variations in Biological Variation (BV) estimates have been reported for urine markers. This study aimed to systematically review and critically appraise BV studies for albumin, creatinine, albumin-to-creatinine ratio (ACR), and other urine markers to perform a meta-analysis of eligible studies. Methods Publications were identified through a systematic search and evaluated using the Biological Variation Data Critical Appraisal Checklist (BIVAC). BIVAC-compliant studies (grades A-C; A being fully compliant) conducted in healthy individuals were included in the meta-analysis, providing within-subject (CVI) and between-subject (CVG) BV estimates with 95% confidence intervals for various sample collection types. Results Out of 37 studies evaluated, 16 were included (one grade A, three B, twelve C). No eligible publications were identified for meta-analysis of albumin and ACR. Limited data were available for first-morning urine specimens. A CVI between 15% and 30% was found for most measurands in 24-hour urine samples, while CVI estimates for random urine appeared higher. Conclusion Published BV studies on urine markers utilized different sample collections and reporting units. Most were considered unfit for use or ineligible for meta-analysis. Given the critical role of urine albumin and ACR in chronic kidney disease risk assessment, there is a need for more BIVAC-compliant studies.

KW - Albumin

KW - Albumin to creatinine ratio

KW - Analytical performance specifications

KW - Biological variation

KW - Creatinine

KW - Albumin excretion rate

KW - Meta-analysis

UR - https://www.scopus.com/pages/publications/85209684540

U2 - 10.1016/j.cca.2024.120032

DO - 10.1016/j.cca.2024.120032

M3 - Article

C2 - 39515634

SN - 0009-8981

VL - 566

JO - Clinica Chimica Acta

JF - Clinica Chimica Acta

M1 - 120032

ER -