Role of dipstick albuminuria in progression of paediatric chronic kidney disease

OBJECTIVE: Renal function of patients with chronic kidney disease (CKD) is typically evaluated by detecting proteinuria because it is a major predictor of CKD progression. In paediatric patients with CKD, urine albumin-to-creatinine ratio (ACR) is used to detect CKD progression, which is similar to urine protein-to-creatinine ratio (PCR). However, facilities for evaluation of urine ACR and urine PCR may not be widely available. To date, this is the first study that investigated the predictive value of baseline dipstick albuminuria for 1-year and 3-year CKD progression in Indonesian children. We assessed the association between baseline level of dipstick albuminuria and CKD progression in paediatric patients. Methods: This retrospective cohort study was conducted at the Cipto Mangunkusumo Hospital (CMH) involving 43 children with CKD between 2016 and 2019. The patients were followed up for 1 year and 3 years after enrolment. Risk ratios (RR) for 1-year and 3-year CKD progression were calculated using Fisher's exact test. RESULTS: The RR for 1-year CKD progression in children with baseline dipstick albuminuria <2+ was 2.16 (95% CI: 1.13-4.14, p = 0.02), and the corresponding RR for 3-year CKD progression in these children was 1.70 (95% CI: 0.73-3.97, p=0.21). CONCLUSIONS: Dipstick albuminuria was not associated with 1-year and 3-year CKD progression in children.