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Albuminuria, proteinuria, and graft survival in kidney transplantation

from American Journal of Kidney Diseases

Nauta et al reported important new information regarding the predictive value of urine biomarkers in kidney transplantation. The investigators also claimed that albuminuria provided better predictions than proteinuria based on ROC (receiver operating characteristic) curves. However, albuminuria and proteinuria were measured at a random time after transplant (25th-75th percentile, 2.6-11.4 years). To uniformly define time relative to transplant, time origins should be related closely to the date of transplant and should be the same for all patients. Otherwise, sensitivity, specificity, and ROC curves should not be estimated, especially in patients with variable follow-up. Nonetheless, performance of the multivariate models using albuminuria or proteinuria can be compared with each other using appropriate methods, such as the Akaike information criterion. more

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