Evaluation of the association between microalbuminuria and the urine albumin-creatinine ratio and systemic disease in dogs

Jacqueline C. WhittemoreDepartment of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523

Search for other papers by Jacqueline C. Whittemore in
Current site
Google Scholar
PubMed
Close
 DVM, DACVIM
,
Virginia L. GillDepartment of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523

Search for other papers by Virginia L. Gill in
Current site
Google Scholar
PubMed
Close
 DVM
,
Wayne A. JensenHeska Corp, 3760 Rocky Mountain Ave, Loveland, CO 80538

Search for other papers by Wayne A. Jensen in
Current site
Google Scholar
PubMed
Close
 DVM, PhD, MBA
,
Steven V. Radecki150 N County Rd 3, Fort Collins, CO 80524

Search for other papers by Steven V. Radecki in
Current site
Google Scholar
PubMed
Close
 PhD
, and
Michael R. LappinDepartment of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523

Search for other papers by Michael R. Lappin in
Current site
Google Scholar
PubMed
Close
 DVM, PhD, DACVIM
View More View Less

Abstract

Objective—To evaluate semiquantitative and quantitative assays for microalbuminuria and determination of the urine albumin-creatinine (UAC) ratio in detection of systemic disease in dogs without overt proteinuria.

Design—Prospective study.

Animals—408 dogs.

Procedures—Urine samples that had been obtained from dogs for which a complete medical record was available and in which results of a dipstick test for urine protein were negative were evaluated. Urine protein-creatinine ratios (cutoff values, 0.5 and 0.1), semiquantitative and quantitative microalbuminuria values (cutoff value, 1 mg/dL), and UAC ratios (cutoff values, 100 and 200 mg/g) were determined. Clinical diagnoses rendered within 3 months of enrollment in the study were recorded. Sensitivity and specificity were determined with disease status serving as the standard. Associations with clinical diagnosis, sex, age, BUN and serum creatinine concentrations, blood pressure, results of bacterial culture of urine, temperature, pyuria, hematuria, and bacteriuria were evaluated by use of logistic regression analysis.

Results—48 dogs were healthy, and 360 had at least 1 disease. Significant associations were detected between age, presence of disease, presence of neoplastic disease, BUN and serum creatinine concentrations, and hematuria and results of 1 or both of the microalbuminuria assays.

Conclusions and Clinical Relevance—Microalbuminuria was associated with underlying disease. The sensitivity and specificity of the semiquantitative microalbuminuria test for detection of systemic disease were superior to those of other tests. Microalbuminuria testing in conjunction with other screening procedures may increase diagnosis of subclinical disease, but a prospective study in which the predictive values of screening tests are evaluated, with and without microalbuminuria determination, is needed.

Abstract

Objective—To evaluate semiquantitative and quantitative assays for microalbuminuria and determination of the urine albumin-creatinine (UAC) ratio in detection of systemic disease in dogs without overt proteinuria.

Design—Prospective study.

Animals—408 dogs.

Procedures—Urine samples that had been obtained from dogs for which a complete medical record was available and in which results of a dipstick test for urine protein were negative were evaluated. Urine protein-creatinine ratios (cutoff values, 0.5 and 0.1), semiquantitative and quantitative microalbuminuria values (cutoff value, 1 mg/dL), and UAC ratios (cutoff values, 100 and 200 mg/g) were determined. Clinical diagnoses rendered within 3 months of enrollment in the study were recorded. Sensitivity and specificity were determined with disease status serving as the standard. Associations with clinical diagnosis, sex, age, BUN and serum creatinine concentrations, blood pressure, results of bacterial culture of urine, temperature, pyuria, hematuria, and bacteriuria were evaluated by use of logistic regression analysis.

Results—48 dogs were healthy, and 360 had at least 1 disease. Significant associations were detected between age, presence of disease, presence of neoplastic disease, BUN and serum creatinine concentrations, and hematuria and results of 1 or both of the microalbuminuria assays.

Conclusions and Clinical Relevance—Microalbuminuria was associated with underlying disease. The sensitivity and specificity of the semiquantitative microalbuminuria test for detection of systemic disease were superior to those of other tests. Microalbuminuria testing in conjunction with other screening procedures may increase diagnosis of subclinical disease, but a prospective study in which the predictive values of screening tests are evaluated, with and without microalbuminuria determination, is needed.

Contributor Notes

Dr. Gill's present address is The Animal Medical Center, 510 E 62nd St, New York, NY 10021.

Supported by a grant from Heska Corporation.

Presented in part as an abstract at the 23rd annual American College of Veterinary Internal Medicine Forum, Baltimore, May 2005.

The authors thank Arianne Morris for assistance.

Address correspondence to Dr. Whittemore.
  • 1

    Hebert LA, Spetie DN, Keane WF. The urgent call of albuminuria/proteinuria: heeding its significance in early detection of kidney disease. Postgrad Med 2001;110:7996.

    • Search Google Scholar
    • Export Citation
  • 2

    Pontremoli R, Leoncini G, Ravera M, et al. Microalbuminuria, cardiovascular, and renal risk in primary hypertension. J Am Soc Nephrol 2002;13:S169S172.

    • Search Google Scholar
    • Export Citation
  • 3

    Ravera M, Ratto E, Vettoretti S, et al. Microalbuminuria and subclinical cerebrovascular damage in essential hypertension. J Nephrol 2002;15:519524.

    • Search Google Scholar
    • Export Citation
  • 4

    Gosling P, Brudney S, McGrath L, et al. Mortality prediction at admission to intensive care: a comparison of microalbuminuria with acute physiology scores after 24 hours. Crit Care Med 2003;31:98103.

    • Search Google Scholar
    • Export Citation
  • 5

    MacKinnon KL, Molnar Z, Lowe D, et al. Use of microalbuminuria as a predictor of outcome in critically ill patients. Br J Anaesth 2000;84:239241.

    • Search Google Scholar
    • Export Citation
  • 6

    DeGaudio AR, Adembri C, Grechi S, et al. Microalbuminuria as an early index of impairment of glomerular permeability in postoperative septic patients. Intensive Care Med 2000;26:13641368.

    • Search Google Scholar
    • Export Citation
  • 7

    Thorevska N, Sabahi R, Upadya A, et al. Microalbuminuria in critically ill medical patients: prevalence, predictors, and prognostic significance. Crit Care Med 2003;31:10751081.

    • Search Google Scholar
    • Export Citation
  • 8

    Szczudlik A, Turaj W, Slowik A, et al. Microalbuminuria and hyperthermia independently predict long-term mortality in acute ischemic stroke patients. Acta Neurol Scand 2003;107:96101.

    • Search Google Scholar
    • Export Citation
  • 9

    Abid O, Sun Q, Sugimoto J, et al. Predictive value of microalbuminuria in medical ICU patients. Chest 2001;120:19841988.

  • 10

    de Jong PE, Hillege HL, Pinto-Sietsma SJ, et al. Screening for microalbuminuria in the general population: a tool to detect subjects at risk for progressive renal failure in an early phase? Nephrol Dial Transplant 2003;18:1013.

    • Search Google Scholar
    • Export Citation
  • 11

    Vaden SL, Pressler BM, Lappin MR, et al. Effects of urinary tract inflammation and sample blood contamination on urine albumin and total protein concentrations in canine urine samples. Vet Clin Pathol 2004;33:1419.

    • Search Google Scholar
    • Export Citation
  • 12

    Mattix HJ, Hsu C, Shaykevich S, et al. Use of the albumin/creatinine ratio to detect microalbuminuria: implications of sex and race. J Am Soc Nephrol 2002;13:10341039.

    • Search Google Scholar
    • Export Citation
  • 13

    Jacobs DR Jr, Murtaugh MA, Steffes M, et al. Gender- and race-specific determination of albumin excretion rate using albuminto-creatinine ratio in single, untimed urine specimens. Am J Epidemiol 2002;155:11141119.

    • Search Google Scholar
    • Export Citation
  • 14

    Jensen WA, Cleland WP, Donnelly R, et al. Identification of underlying disease in dogs that test positive with the ERD-HealthScreen Canine Urine Test. Loveland, Colo: Heska Corp, 2003. Available at: www.heska.com/erd/data_572.asp. Accessed Aug 1, 2006.

    • Search Google Scholar
    • Export Citation
  • 15

    Syme HM, Markwell PJ, Pfeiffer D, et al. Survival of cats with naturally occurring chronic renal failure is related to severity of proteinuria. J Vet Intern Med 2006;20:528535.

    • Search Google Scholar
    • Export Citation
  • 16

    Lees GE, Brown SA, Elliott J, et al. Assessment and management of proteinuria in dogs and cats: 2004 ACVIM Forum consensus statement (small animal). J Vet Intern Med 2005;19:377385.

    • Search Google Scholar
    • Export Citation
  • 17

    Pinto-Sietsma SJ, Janssen WMT, Hillege HL, et al. Urinary albumin excretion is associated with renal functional abnormalities in a nondiabetic population. J Am Soc Nephrol 2000;11:18821888.

    • Search Google Scholar
    • Export Citation
  • 18

    Hallan H, Romundstad S, Kvenild K, et al. Microalbuminuria in diabetic and hypertensive patients and the general population. Scand J Urol Nephrol 2003;37:151158.

    • Search Google Scholar
    • Export Citation
  • 19

    Kramer HJ, Nguyen QD, Curhan G, et al. Renal insufficiency in the absence of albuminuria and retinopathy among adults with type 2 diabetes mellitus. JAMA 2003;289:32733277.

    • Search Google Scholar
    • Export Citation
  • 20

    Selby JV, Karter AJ, Ackerson LM, et al. Developing a prediction rule from automated clinical databases to identify high-risk patients in a large population with diabetes. Diabetes Care 2001;24:15471555.

    • Search Google Scholar
    • Export Citation
  • 21

    Wisnewski N, Clarke KB, Powell TD, et al. Prevalence of microalbuminuria in cats. Loveland, Colo: Heska Corp, 2003. Available at: www.heska.com/erd/data_cat.asp. Accessed Aug 1, 2006.

    • Search Google Scholar
    • Export Citation

Advertisement