First morning void urine samples yielded a microalbuminuria prevalence of 7.5%, closely matching the 10.0% prevalence from 24-hour collections, whereas spot urine samples overestimated it at 25.4% (P<0.001).
Observational (n=241)
No
Absolute Event Rate: 7.5% vs 10%
p-value: p=0.18
Measurement of urinary albumin excretion (UAE) in a 24-h collection is the gold standard method to determine the presence of microalbuminuria. We sought to compare more practical alternatives--measurement of urinary albumin concentration (UAC) or albumin:creatinine ratio (ACR)--in a first morning void or in a spot urine sample with this gold standard. We asked 241 participants of a prospective cohort study to make three 24-h urine collections, a first morning void, and a spot urine sample. Regression analysis showed that the ACR in a first morning void best agreed with 24-h UAE. The prevalence of microalbuminuria determined by data from a first morning void (7.5%, whether by UAC or ACR) nearly equaled the prevalence of microalbuminuria determined by 24-h UAE (10.0%), whereas the prevalence was higher when determined by spot urine samples (25.4% for UAC and 22.4% for ACR; both P < 0.001 versus 24-h UAE). The intraindividual coefficients of variation of the ACR in a first morning void and 24-h UAE were similar (19%). Intraindividual coefficients of variations of all other measurements of albuminuria were significantly greater. In conclusion, measurement of albuminuria in a first morning void, preferably as the ACR, is more reliable than a spot urine sample to diagnose and monitor microalbuminuria.
Witte et al. (Thu,) conducted a observational in Microalbuminuria (n=241). First morning void urine sample vs. 24-hour urine collection (gold standard) and spot urine sample was evaluated on Prevalence of microalbuminuria (p=0.18). First morning void urine samples yielded a microalbuminuria prevalence of 7.5%, closely matching the 10.0% prevalence from 24-hour collections, whereas spot urine samples overestimated it at 25.4% (P<0.001).